progressive massive fibrosis

Definition

Acute silicosis

Alternative Names

Causes

The disease occurs mainly in people who work in sandblasting, mining, quarrying, grinding, and those who work in foundries. Silicosis is becoming less common due to U.S. Occupational Safety and Health Administration (OSHA) regulations that require protective equipment.

Symptoms

• Shortness of breath
• Cough
• Unintentional weight loss

Exams and Tests

The mucous membranes may have a bluish color (cyanosis). Often, the doctor can hear abnormal lung sounds with a stethoscope.

Tests that may be done include:

• Chest x-ray
• Pulmonary function tests
• Arterial blood gases
• Chest CT scan
• Lung biopsy
• Bronchoscopy with bronchoalveolar lavage (BAL)
• Sputum analysis

Treatment

There is no specific treatment for silicosis. Whole-lung lavage or treatment with corticosteroids may be attempted. For those with end-stage lung disease, lung transplantation may be an option.

Supportive treatment includes cough suppression medications, bronchodilators, and oxygen if needed for shortness of breath. Antibiotics are prescribed for respiratory infections as needed. In general, silicosis patients should be screened for tuberculosis and treated if indicated.

Outlook (Prognosis)

The outcome depends on the severity of lung scarring. The severity of the disease is usually related to the amount of silica to which the person was exposed. Acute silicosis has a poor prognosis.

Possible Complications

A complication is respiratory failure. Patients with silicosis are at increased risk of developing pulmonary tuberculosis.

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have occupational exposure to silica and you develop symptoms.

Prevention

If you work in a high-risk occupation, wear a dust mask and do not smoke. You also may need other protection, such as a respirator.

Ferri FF. Ferri's Clinical Advisor 2007: Instant Diagnosis and Treatment. 9th ed. Philadelphia, Pa: Mosby; 2006.

Glazer CS, Newman LS. Occupational interstitial lung disease. Clin Chest Med. September 2004;25:467-478.

Pipavath S, Godwin JD. Imaging of interstitial lung disease. Clin Chest Med. September 2004;25:455-465.