Synopsis
Recognise silica and coal-dust pneumoconiosis, identify accelerated disease and tuberculosis, stop hazardous exposure and provide specialist, occupational and statutory support.
- Pneumoconiosis describes diffuse lung disease caused by retained inhaled mineral dust; silicosis and coal-worker pneumoconiosis are important UK occupational examples.
- Respirable crystalline silica arises from stone, rock, sand and clay, with high-risk tasks including cutting engineered stone, dry grinding, tunnelling, quarrying and sandblasting.
- Silicosis may be chronic after long latency, accelerated after intense exposure over fewer years, or acute after very high exposure.
Key red flags
High-intensity exposure, particularly dry engineered-stone processing or sandblasting, is followed within a shorter latency by rapidly worsening cough, breathlessness, diffuse opacity or alveolar-filling disease.
Investigation priorities
Estimate dust type, intensity, duration, latency and current exposure.
Management branches
Nodular or fibrotic lung disease appears in a person with possible mineral-dust exposure.
- Assess respiratory stability and infectious red flags, then build a detailed exposure chronology covering materials, processes, visible dust and controls across every job and hobby.
- Obtain chest imaging, full pulmonary function and exercise oxygenation; ask thoracic radiology to distinguish small-opacity disease, progressive massive fibrosis, emphysema and suspicious focal lesions.
Key medicines
Controlled oxygenFor acute hypoxaemia target 94–98% in most adults or 88–92% if at risk of hypercapnic respiratory failure, pending blood gases and an individual prescription.
Inhaled bronchodilator for coexisting obstructive diseaseSelect the inhaler and licensed dose from objective COPD or asthma assessment, inhaler technique, current NICE guidance and the local formulary; there is no pneumoconiosis-specific bronchodilator regimen.