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Neumoconiosis

Last reviewed: 30 Apr 2025
Last updated: 17 Jan 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
Full details

Other diagnostic factors

  • disnea de esfuerzo
  • tos
  • exploración física de tórax normal
  • crepitantes durante la auscultación pulmonar
  • opresión en el pecho o sibilancias
  • espiración prolongada y sibilancias en la auscultación pulmonar
  • áreas de matidez en la percusión torácica
  • cianosis
  • tórax en tonel
  • hemoptisis, fiebre o sudores nocturnos
  • hipocratismo digital de las manos y los pies
  • pérdida de peso
  • signos de artritis reumatoide o esclerodermia
  • signos de insuficiencia renal (p. ej., aumento de peso, edema, hipertensión)
Full details

Risk factors

  • exposición laboral a la sílice
  • exposición laboral al carbón
  • exposición laboral al berilio
  • dosis de carbón o sílice inhalados de alta acumulación
  • tabaquismo
  • ácido glutámico en la posición 69 de la cadena B1 de la molécula HLA-DP (enfermedad crónica por berilio)
  • dosis de berilio inhalado de alta acumulación
Full details

Diagnostic investigations

1st investigations to order

  • radiografía de tórax (posteroanterior y lateral)
  • espirometría
  • prueba de proliferación de linfocitos de berilio (BeLPT)
Full details

Investigations to consider

  • biopsia broncoscópica y/o lavado
  • exploración de tórax por tomografía computarizada (TC) de alta resolución (HRCT)
  • saturación de oxígeno
  • gasometría arterial (GSA)
  • biopsia pulmonar
  • prueba de la tuberculosis (TB)
Full details

Treatment algorithm

ACUTE

proteinosis alveolar secundaria aguda (silicosis aguda)

beriliosis aguda

ONGOING

silicosis crónica, pulmón de los trabajadores del carbón o beriliosis crónica

Contributors

Authors

Kenneth D. Rosenman, MD

Professor of Medicine

Division of Occupational and Environmental Medicine

Michigan State University

East Lansing

MI

Disclosures

KDR declares no competing interests.

Peer reviewers

Ware G. Kuschner, MD

Associate Professor of Medicine

Stanford University

Staff Physician

US Department of Veterans Affairs

Palo Alto Health Care System

Palo Alto

CA

Disclosures

WGK declares that he has no competing interests.

Harman Paintal, MBBS

Division of Pulmonary and Critical Care Medicine

Veterans Affairs Palo Alto Health Care System (VAPAHCS)

Palo Alto

CA

Disclosures

HP declares that he has no competing interests.

Francis Thien, MD, FRACP, FCCP

Professor

Box Hill Hospital and Monash University

Victoria

Australia

Disclosures

FT declares that he has no competing interests.

Edward L. Petsonk, MD

Professor of Medicine

Section of Pulmonary and Critical Care Medicine

West Virginia University School of Medicine

Morgantown

WV

Disclosures

ELP declares that he has no competing interests.

Christopher M. Barber, BM, BS, BMedSci, FRCP, MD, AFOM

Respiratory Consultant

Sheffield Teaching Hospitals NHS Foundation Trust

Sheffield

UK

Disclosures

CMB declares that he has no competing interests.

Carl J. Reynolds, MBBS, MRCP, BSc, MSc, PhD, DPMSA

Respiratory Consultant

Honorary Senior Clinical Lecturer

North Middlesex University Hospital

Imperial College London

UK

Disclosures

CJR declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Balmes JR, Abraham JL, Dweik RA, et al. An official American Thoracic Society statement: diagnosis and management of beryllium sensitivity and chronic beryllium disease. Am J Respir Crit Care Med. 2014 Nov 15;190(10):e34-59.Full text  Abstract

American College of Radiology. ACR Appropriateness Criteria: occupational lung diseases. 2019 [internet publication].Full text

National Institute for Occupational Safety and Health. Health effects of occupational exposure to respirable crystalline silica. Apr 2002 [internet publication].Full text

International Labour Office. Guidelines for the use of the ILO international classification of radiographs of pneumoconioses, revised edition. 2022 [internet publication].Full text

US Occupational Safety and Health Administration (OSHA). Final rule to protect workers from occupational exposure to respirable crystalline silica. Appendix B to §1926.1153 construction standard - medical surveillance guidelines. Jun 2016 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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