I. How is the imaging grading of pneumoconiosis performed in 2009? According to the National Occupational Health Standards – Diagnostic Criteria for Pneumoconiosis promulgated in 2009, the specific diagnostic grading of pneumoconiosis is as follows: 1. Subject of observation Those who have indeterminate pneumoconiosis-like imaging changes on X-ray chest radiographs of dust operators, the nature and extent of which require dynamic observation within a certain period of time. Ye Suyi, Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital 2, Pneumoconiosis stage I There are small shadows of overall intensity grade 1, with distribution reaching at least 2 lung areas. 3.Pneumoconiosis stage II Small shadows of overall intensity grade 2 with a distribution of more than 4 lung areas; or small shadows of overall intensity grade 3 with a distribution of 4 lung areas. 4, pneumoconiosis stage III One of the following three manifestations: (1) the presence of large shadows, the long diameter of which is not less than 20mm, the short diameter is not less than 10mm; (2) the overall density of small shadows grade 3, the distribution range of more than 4 lung areas and the aggregation of small shadows; (3) the overall density of small shadows grade 3, the distribution range of more than 4 lung areas and the presence of large shadows. II. How is pneumoconiosis diagnosed? Pneumoconiosis can be diagnosed based on a reliable history of productive dust exposure, with chest imaging manifestations as the main basis, combined with on-site occupational hygiene, pneumoconiosis epidemiological survey data and health monitoring data, with reference to clinical manifestations and laboratory tests, and after excluding other similar diseases of the lungs. Percutaneous puncture of large shadows in the lungs for biopsy, as well as transbronchial lung biopsy are of value in supporting the diagnosis and differential diagnosis. When making a diagnosis of occupational pneumoconiosis, a diagnosis of occupational pneumoconiosis needs to be made against a pneumoconiosis diagnostic standard film with an overall density of small shadows of at least grade 1 and a distribution of at least 2 lung areas. 3. What are the complications of pneumoconiosis? 1. Respiratory infections: bronchitis and pneumonia are the most common complications of pneumoconiosis. 2, spontaneous pneumothorax: lung tissue and dirty layer pleura rupture, air enters the pleura to form pneumothorax, which can be closed pneumothorax, tension pneumothorax or traffic pneumothorax. Take oxygen therapy, closed thoracic drainage or surgical thoracoscopic surgery treatment. 3, tuberculosis: more common, silica dust patients are more likely to complicate tuberculosis. Patients with pneumoconiosis tuberculosis often have shorter pneumoconiosis progression time and accelerated respiratory function deterioration. 4, lung cancer, mesothelioma: seen in asbestos workers and asbestos lung patients, silica dust is also a class I carcinogen. 5, chronic pulmonary heart disease: seen in patients with advanced pneumoconiosis, mostly due to chronic bronchitis causing airway narrowing, increased ventilation resistance, obstructive emphysema, and hypoxemia, resulting in pulmonary arterial pressure hypertension, and involvement of the heart, pulmonary heart disease occurs. 6. Respiratory failure: The progression of pneumoconiosis, combined lung infections, pneumothorax and other comorbidities in pneumoconiosis patients are the main reasons for the occurrence of respiratory failure, which requires oxygen therapy and respiratory support treatment. IV. What is the treatment strategy for pneumoconiosis? After the diagnosis of pneumoconiosis is confirmed, transfer out of dust work, symptomatic supportive treatment, and active comorbidity should be done as soon as possible according to national regulations. 1. General treatment: pay attention to physical and mental health, reasonable nutrition, and rehabilitation exercises to enhance body resistance and improve quality of life. Active symptomatic treatment to reduce cough, coughing and shortness of breath symptoms. Patients with hypoxia need a long course of home oxygen therapy. 2, drug therapy: pneumoconiosis so far there is no effective drugs or therapy, currently more drugs are used mainly by Kresilpine, piperaquine, powder antibiotics, organic aluminum preparations, etc.. There is still a lack of large samples of randomized controlled studies to evaluate the safety and efficacy of drugs. 3, . Lung transplantation: an effective means of treating advanced silicosis, patients with indications should be included in the waiting list for transplantation as early as possible and undergo a standardized pre-transplantation evaluation. China is limited to the immature development of lung transplantation technology, limited sources of donor organs, and high costs, which limit the development of lung transplantation. 4. Whole lung lavage: Whole lung lavage in early pneumoconiosis patients can reduce the patient’s respiratory symptoms and reduce the load of dust deposition in the lungs. Current studies have found that whole lung lavage does not delay the reduction of lung function and has no improvement on chest imaging. There is a lack of evidence-based medical evidence to support whole lung lavage techniques for the treatment of pneumoconiosis. 5. Prevention and treatment of complications.