Overview of Talc Pneumoconiosis
Talc pneumoconiosis is a disease of diffuse fibrosis caused by long-term inhalation of talc dust, which belongs to silicate pneumoconiosis. Talc pneumoconiosis is mainly seen in talc mining, processing, storage, transportation and use of workers, the onset of the age of the work is generally more than 10 years, mostly between 20 and 30 years. Talc dust has a relatively low pathogenicity, and the lesions may stop progressing or progress slowly after being detached from exposure to the dust, with individual cases progressing more rapidly.
Etiology
Talc is a secondary mineral that is formed by the alteration of magnesium-containing silicates or carbonates. The composition of talc varies greatly from deposit to deposit due to the degree of alteration, thus causing different pathologic changes.
The pathological changes of talc pneumoconiosis include three kinds: nodular lesions, diffuse interstitial fibrosis and foreign body granuloma. Asbestos microsomes” can be found in the lungs, and there is a limited proliferation of pleural plaques (or talc plaques).
Symptoms
In the early stage, there are no special changes, but in the late stage, respiratory symptoms, such as shortness of breath, chest pain, cough, etc., may appear to varying degrees, but they are less severe than those of silicosis and asbestosis. In cases with foreign body granuloma, progressive dyspnea may occur. Patients with talcum pneumoconiosis are often combined with tuberculosis.
Examination
Chest X-ray examination mainly shows mixed small shadows, i.e., small rounded shadows scattered on the background of irregular small shadows, “s” and “t” are common, and the shadows are shallowly dense with clear edges. In some cases, the X-ray changes are dominated by small irregular shadows, similar to asbestosis. In advanced cases, large shadows due to massive fibrosis are seen. Talc plaques are seen at the lateral chest wall, diaphragm, or pericardium, which are linear or unshaped.
Diagnosis.
The diagnosis is made on the basis of a detailed occupational history and x-ray findings and other clinical manifestations. A detailed investigation of the operating environment and the grade and composition of the talc to which one is exposed is useful in estimating the extent and character of lung damage. Examination of sputum or lung lavage fluid may reveal talc particles or asbestos-like vesicles. Lung biopsy is useful in the diagnosis and differential diagnosis of talc lung. Sampling via fiberoptic bronchoscopy is easily accepted by patients.
Complications
Advanced cases can be complicated by respiratory infections and can be complicated by pulmonary heart disease. The prevalence of tuberculosis is higher in talc workers and patients with talc lung. It can also lead to the development of lung tumors.
Treatment
1. Symptomatic treatment, advanced patients should prevent and treat complications.
2. In cases of foreign body granuloma, symptoms disappear after long-term treatment with hormones, lung function improves and chest X-ray changes subside.
3. Inhalation of talcum powder in large quantities at one time can cause acute lung damage, especially in young children prone to bronchitis, fine bronchitis, airway obstruction, wheezing state, emphysema, pulmonary atelectasis and so on. Bronchodilators, cardiotonic agents, respiratory stimulants, oxygen, mechanical ventilator antibiotics can be applied. To clear bronchial obstruction, bronchopulmonary lavage is feasible.
Prevention
The key to prevent talcum pneumoconiosis is to prevent the inhalation of harmful dust to the maximum extent possible, as long as the measures are appropriate is completely preventable.
1. Improvement of engineering technology in production enterprises to eliminate or reduce dust;
2. Doing a good job of personal protection and hygiene for high-risk groups;
3. Strengthening technical management and establishing necessary dust prevention systems and equipment;
4. Regular health checkups for high-risk groups and early detection of suspected or diagnosed patients so that measures can be taken to prevent and slow down the development and deterioration of the disease.