Asbestosis is the most important change noted in the lung parenchyma after environmental and occupational exposure to asbestos fibers. It is characterized by diffuse interstitial pulmonary fibrosis. In Korea, the incidence of asbestosis will continue to increase for many years to come and the government enacted the Asbestos Damage Relief Law in 2011 to provide compensation to those suffering from asbestos-related diseases. Radiologic evaluation is necessary for diagnosis of asbestosis, and radiologists play a key role in this process. Therefore, it is important for radiologists to be aware of the various imaging features of asbestosis.
Asbestos ; Asbestosis* ; Compensation and Redress ; Diagnosis* ; Incidence ; Jurisprudence ; Korea* ; Lung ; Occupational Diseases ; Occupational Exposure ; Pulmonary Fibrosis ; Radiography

The classification for pneumoconiosis which was developed by International Labour Office(ILO) on the basis of Radiological findings of simple chest radiography has been widely used for the study and diagnosis of pneumoconiosis. But many problems have been revealed during the pneumoconiosis study using this classification. Those problems come from simple radiography itself or classification systems. Among those, inter-reader and intra-reader variability are the severest problems, even though many efforts have been devoted to lessen the variability. With introduction of computed tomography (conventional CT and HRCT), we are learning many new aspects about the occupational lung diseases, especially pneumoconiosis. So the studies for pneumoconiosis using tomography are reviewed, focusing on silicosis, coalworkers' pneumoconiosis, and asbestosis. But in our country, the studies of that kind are very scant. It is necessary to study and diagnose pneumoconiosis by CT, because that is the need of workers and the responsibility of physicians working in the field of occupational medicine. CT is superior to simple radiography in early detection, determination of severity, and follow-up of pneumoconiosis. But simple radiography is and should be the main method for the study and diagnosis of pneumoconiosis. Although, because of radiation hazard, cost, time, and geographical availability, the method can not and should not be used on the routine basis, we have to consider the use of CT, if possible and if necessary. Before using CT widely, we should develop the standardized criteria regarding to scanning methods and reading criteria. If not, the same problems as those of simple radiography will be occurred, and then there will be no progress in occupational medicine and workers' health.
Asbestosis ; Classification ; Diagnosis* ; Follow-Up Studies ; Learning ; Lung Diseases ; Occupational Medicine ; Pneumoconiosis* ; Radiography* ; Silicosis ; Thorax

We report a case of pulmonary fibrosis in a 32-year-old man, who had worked at a steel mill and who died of respiratory failure due to interstitial fibrosis despite vigorous treatment. He showed SLE-associated symptoms, such as pleural effusion, malar rashes, discoid rashes, arthritis, leukopenia, and positive antinuclear antibody and anti-histone antibody. However, he did not present anti-DNA antibody. A thoracoscopic lung biopsy showed interstitial fibrosis, chronic inflammation and a small non-caseating granuloma in lung tissues, which could be induced by external agents such as metals. The manganese concentration in the lung tissue was 4.64 microg/g compared to 0.42-0.7 microg/g in the controls. The levels of other metals, such as iron, nickel, cobalt and zinc in patient's lung tissue were higher than those in the controls. The patient was probably exposed to Si and various metal dusts, and the lung fibrosis was related to these exposures. Exposure to Si and metal dusts should be sought in the history of any patient with SLE, especially in a male with pulmonary signs, and if present, exposure should be stopped. In the meantime, steps should be taken to ensure that workers exposure to Si and metal dusts in all environments have adequate protection.
Adult ; Biopsy ; Case Report ; Fatal Outcome ; Human ; Male ; Occupational Diseases/radiography* ; Occupational Diseases/pathology ; Occupational Diseases/chemically induced* ; Occupational Exposure ; Pulmonary Alveoli/pathology ; Pulmonary Fibrosis/radiography* ; Pulmonary Fibrosis/pathology ; Pulmonary Fibrosis/chemically induced* ; Respiratory Insufficiency/radiography ; Respiratory Insufficiency/pathology ; Respiratory Insufficiency/chemically induced ; Steel/adverse effects*

Pneumoconiosis is one of the most important occupational disease in Korea. In Pusan, most of pneumoconiosis is welders' pneumoconiosis developed in shipyard. With clinical (including interview with every patients) and radiological (chest radiographs) methods, author purposed to know the factors related to development of pneumoconiosis in shipyard welders and to apply the results to the concept for health care (management) of shipyard welders. The prevalence rate of welders' pneumoconiosis was calculated by the means of reading of chest radiographs of 547 shipyard welders. The prevalence rate of welders' pneumoconiosis (including suspected pneumoconiosis, category 0/1) was 7.9%. It was lower than that (8.9%) in same area studied in 1989. Prevalence rate increased as total welding duration increased and the welding work began early. It was higher in welders who did not use antidust mask. Probability of the occurance of welder's pneumoconiosis was related with the time that the welder began welding work. Sixteen cases among the 37 who were diagnosed as pneumoconiosis returned normal in the follow-up chest radiographs. There was no case aggrevated. The pertinent management for the personnels and their working environment contributed to the decrease of incidence of the welders' pneumoconiosis and the improvement of the disease. To prevent the occurance of the pneumoconiosis in shipyard welders, it seems to be necessary for the company to be supervised under the any legislation and to educate the welder to use the protective apparatus. It is suggested that considerate and continuous observation under the adequate management is preferable to the immediate conversion of the working department for the pneumoconiotic welders.
Busan ; Delivery of Health Care ; Follow-Up Studies ; Incidence ; Korea ; Masks ; Occupational Diseases ; Pneumoconiosis* ; Prevalence ; Radiography, Thoracic ; Welding

Pneumoconiosis was diagnosed by open lung biopsy in two dental technicians who had interstitial lung disease. Mineralogical analysis was performed to investigate the origin of the dust that had been inhaled. A marked accumulation of silicon and phosphorus was found in both cases. The hard metals chromium and cobalt were also found. Dental technician's pneumoconiosis is a complex pneumoconiosis in which such dust and hard metals may play a role.
Adult ; *Dental Technicians ; Human ; Lung/pathology ; Lung Diseases, Interstitial/*diagnosis/metabolism ; Male ; Minerals/metabolism ; Occupational Diseases/*diagnosis/metabolism ; Pneumoconiosis/*diagnosis/metabolism ; Radiography, Thoracic ; Tomography, X-Ray Computed

OBJECTIVETo study the respiratory system injury in fur processing environment.

METHODSEnvironmental fungal survey was conducted in the fur processing procedures. Investigation of respiratory symptoms and chest X-ray examination were also carried out in 138 fur processing workers and 40 control workers. At the same time, the serum antibodies to fungi were analyzed by ELISA.

RESULTSFungal number(629-3,681 cfu/m3) in fur processing procedures was much higher than those in the control environment. Cladosporium and Alternaria were the leading strains of fungi in fur processing procedures. The rates of respiratory symptoms(cough, sputum, chest tightness, dyspnea, and fever) in fur processing workers were higher than those in the control workers. The rates of the symptoms in female workers were 37.9%, 28.4%, 10.5%, 22.1%, 4.2%, respectively. Abnormalities of chest X ray were found in 7 workers. The serum antibodies to Cladosporium and Alternaria(A450 nm 0.631, 0.724, respectively) in fur workers were significantly higher than those in the control workers(P < 0.05). The positive rates of the antibodies to Cladosporium and Alternaria(44.2%, 42.8%) were significantly higher than those in the control workers(P < 0.01).

CONCLUSIONCladosporium and Alternaria may be the pathogens of occupational respiratory diseases in fur processing workers.

Alternaria ; isolation & purification ; Antibodies, Fungal ; blood ; Cladosporium ; isolation & purification ; Environmental Microbiology ; Female ; Hair ; Humans ; Occupational Diseases ; etiology ; Radiography, Thoracic ; Respiratory Tract Diseases ; etiology

Occupational lung diseases caused by metal oxide are classified as follows, metal fume fever, chemical pneumonitis, hypersensitivity pneumonitis, and occupational asthma. Even though it's well known the immunologic mechanism is involved in metal fume fever, the exact cause is unkown yet. Some authors have speculated that metal fume fever is a form of hypersensitivity pneumonitis. A smelter exposed to metal oxide fumes was hospitalized with some complaints such as severe cough, dyspnea and fever. Chest radiographs on admission showed ill-defined reticulonodular density especially prominent in the base of the both lower lobe. HRCT of chest was observed diffuse fine granolar and reticular involvement with multiple small honeycomb cystic lesion. Bronchoalveolar lavage showed a lymphocyte predominant alveolitis and TBLB had the finding of noncaseating granuloma infiltrating with giant cells, lymphocytes and macrophages. This is a case of alveolitis caused by metal oxide fume which has the characteristics of hypersensitivity pneumonitis in clinical picture and the finding of BAL and TBLB.
Alveolitis, Extrinsic Allergic* ; Asthma, Occupational ; Bronchoalveolar Lavage ; Cough ; Dyspnea ; Fever ; Giant Cells ; Granuloma ; Hypersensitivity* ; Lung Diseases ; Lymphocytes ; Macrophages ; Pneumonia ; Radiography, Thoracic ; Thorax

OBJECTIVE: This study evaluated the CT characteristics of pleural plaques in asbestos-exposed individuals and compared occupational versus environmental exposure groups. MATERIALS AND METHODS: This study enrolled 181 subjects with occupational exposure and 98 with environmental exposure from chrysotile asbestos mines, who had pleural plaques confirmed by a chest CT. The CT scans were analyzed for morphological characteristics, the number and distribution of pleural plaques and combined pulmonary fibrosis. Furthermore, the CT findings were compared between the occupational and environmental exposure groups. RESULTS: Concerning the 279 subjects, the pleural plaques were single in 2.2% and unilateral in 3.6%, and showed variable widths (range, 1-20 mm; mean, 5.4 +/- 2.7 mm) and lengths (5-310 mm; 72.6 +/- 54.8 mm). The chest wall was the most commonly involved (98.6%), with an upper predominance on the ventral side (upper, 77.8% vs. lower, 55.9%, p < 0.001) and a lower predominance on the dorsal side (upper, 74.9% vs. lower, 91.8%, p = 0.02). Diaphragmatic involvement (78.1%) showed a right-side predominance (right, 73.8% vs. left, 55.6%, p < 0.001), whereas mediastinal plaques (42.7%) were more frequent on the left (right, 17.6% vs. left, 39.4%, p < 0.001). The extent and maximum length of plaques, and presence and severity of combined asbestosis, were significantly higher in the occupational exposure group (p < 0.05). CONCLUSION: Pleural plaques in asbestos-exposed individuals are variable in number and size; and show a predominant distribution in the upper ventral and lower dorsal chest walls, right diaphragm, and left mediastinum. Asbestos mine workers have a higher extent of plaques and pulmonary fibrosis versus environmentally exposed individuals.
Adult ; Aged ; Aged, 80 and over ; Asbestos, Serpentine/*toxicity ; Asbestosis/*etiology/radiography ; Asian Continental Ancestry Group ; Environmental Pollutants/toxicity ; Female ; Humans ; Male ; Middle Aged ; Mining ; Occupational Exposure ; Pleural Diseases/*etiology/radiography ; Republic of Korea ; Tomography, X-Ray Computed