Bronchoalveolar Lavage in Occupational Lung Diseases (original) (raw)
A Clinical Guide to Occupational and Environmental Lung Diseases
Humana Press eBooks, 2012
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Role of Bronchoalveolar Lavage in Hypersensitivity Pneumonitis (HP) Diagnosis
Hypersensitivity pneumonitis (HP) is a complex inflammatory lung disease caused by repeated inhalational exposure to sensitized antigens. The clinical presentation varies from acute, reversible inflammation to chronic, progressive fibrosis, posing diagnostic and therapeutic challenges. Diagnosis requires a multidisciplinary approach integrating history, imaging, laboratory tests, and histopathology. High-resolution CT (HRCT) and bronchoalveolar lavage (BAL) findings provide critical diagnostic clues. Management focuses on antigen avoidance, corticosteroid therapy, and immunosuppressants for progressive cases. Chronic HP with fibrosis is associated with significant morbidity and poor prognosis. Early diagnosis and preventive measures are key to improved outcomes.
2013
In recent years the greatest progress in our understanding of pneumoconioses, other than those produced by asbestos, silica, and coal, has been in the arena of metal-induced parenchymal lung disorders. Inhalation of metal dusts and fumes can induce a wide range of lung pathology, including airways disorders, cancer, and parenchymal diseases. The emphasis of this update is on parenchymal diseases caused by metal inhalation, including granulomatous disease, giant cell interstitial pneumonitis, chemical pneumonitis, and interstitial fibrosis, among others. The clinical characteristics, epidemiology, and pathogenesis of disorders arising from exposure to aluminum, beryllium, cadmium, cobalt, copper, iron, mercury, and nickel are presented in detail. Metal fume fever, an inhalation fever syndrome attributed to exposure to a number of metals, is also discussed. Advances in our knowledge of antigen-specific immunologic reactions in the lung are particularly evident in disorders secondary t...
Hypersensitivity pneumonitis in man. Light- and electron-microscopic studies of 18 lung biopsies
American Journal Of Pathology
Light-and electron-microscopic changes produced by hypersensitivity pneumonitis were analyzed in open lung biopsies taken from 18 patients with chronic forms of the disease. The main changes observed were: alveolitis (both luminal and mural), granulomas, intraalveolar buds, and interstitial fibrosis. The cells infiltrating the alveolar walls were mainly lymphocytes. Occasionally these lymphocytes presented irregularities in the contours of the nuclear membranes and resembled Sezary cells. In one patient, a few lymphocytes were found that resembled "hand-mirror" cells. Intraalveolar macrophages often had a foamy appearance. Granulomas, present in two-thirds of the patients, differed in several respects from those in sarcoidosis: they were smaller, more loosely arranged, and poorly limited; they had a higher content of lymphocytes; and they were located more frequently in HYPERSENSITIVITY PNEUMONITIS is an interstitial lung disorder resulting from a reaction of predisposed individuals to repeated inhalation of organic particulates.1`7 Although the pathogenesis of this disorder is not completely understood, it clearly results from the immunologic reaction to antigens associated with the organic particulate. In this regard, patients with hypersensitivity pneumonitis characteristically have both cellular and humoral immune processes directed against the organic particulate. However, even though many different substances are known to induce hypersensitivity pneumonitis, the resulting changes within the lung parenchyma are thought to be similar.3
Occupational and Environmental Lung Disease
Oxford University Press eBooks, 2012
Occupational and environmental lung disease is a major cause of respiratory impairment worldwide. Despite regulations, exposures to the "classic" dusts, such as silica, coal, and asbestos, continue to be a worldwide cause of disease. New etiologies for occupational lung disease continue to emerge, and known causes are emerging in new industries. Nonoccupational environmental lung disease contributes to major respiratory disease, asthma, and chronic obstructive pulmonary disease. Knowledge of the imaging patterns of occupational and environmental lung disease is critical in managing patients with suspected or occult exposures.
Non-fibrous inorganic particles in bronchoalveolar lavage fluid of pottery workers
Occupational and Environmental Medicine, 1996
Aim-To study the actual exposure of pottery workers to silica particles, as their risk of silicosis is potentially high because ofthe presence ofinhalable crystalline silica particles in the workplace. Methods-Nine pottery workers underwent bronchoalveolar savage. The recovered fluid was analysed for cytological and mineralogical content by analytical transmission electron microscopy. The data were compared with those obtained from a control group composed of seven patients with sarcoidosis and six patients with haemoptysis. Results-Cytological results showed a similar profile in exposed workers and controls, whereas in patients with sarcoidosis a lymphocytic alveolitis was found. Microanalysis of the particulate identified the presence of silicates, CRSs, and metals. Pottery workers had higher numbers of total particles and CRSs, and had a higher silicatelmetal ratio. In five workers, the presence of zirconium silicate was also detected. Patients with sarcoidosis had the lowest number of particles, and an inverted silicatelmetal ratio.
Occupational lung diseases: from old and novel exposures to effective preventive strategies
The Lancet. Respiratory medicine, 2017
Occupational exposure is an important, global cause of respiratory disease. Unlike many other non-communicable lung diseases, the proximal causes of many occupational lung diseases are well understood and they should be amenable to control with use of established and effective approaches. Therefore, the risks arising from exposure to silica and asbestos are well known, as are the means of their prevention. Although the incidence of occupational lung disease has decreased in many countries, in parts of the world undergoing rapid economic transition and population growth-often with large informal and unregulated workforces-occupational exposures continue to impose a heavy burden of disease. The incidence of interstitial and malignant lung diseases remains unacceptably high because control measures are not implemented or exposures arise in novel ways. With the advent of innovative technologies, new threats are continually introduced to the workplace (eg, indium compounds and vicinal di...