I. Definition Pneumoconiosis is a disease caused by long-term inhalation of dust, mainly due to fibrotic lesions of lung tissue, with high prevalence, long latency period, slow onset, many late complications, poor treatment, high disability and death rates. According to the data of special survey of occupational diseases and occupational disease reports in China, silicosis and coal workers are the most important pneumoconiosis in China, accounting for about 90% of the total number of pneumoconiosis. It is mainly distributed in coal, metallurgy, non-ferrous, building materials, machinery, gold and other industrial industries. According to the survey, by 2007 there were over 15,000 pneumoconiosis patients in our province, and more seriously, there are a large number of asymptomatic pneumoconiosis patients. Second, the classification of pneumoconiosis Due to the different types and nature of inhaled dust, the types of pneumoconiosis, the occurrence and development of lesions also vary. Depending on the type of dust, there are 12 types of pneumoconiosis in China, namely silicosis, coal workers’ pneumoconiosis, graphite pneumoconiosis, carbon black pneumoconiosis, asbestos pneumoconiosis, talc pneumoconiosis, cement pneumoconiosis, mica pneumoconiosis, potter’s pneumoconiosis, aluminum pneumoconiosis, welding pneumoconiosis, and cast pneumoconiosis. The main fields of operation that cause pneumoconiosis are: mining and blasting of various gold mines and coal mines; crushing, sieving and transportation of ores; sand preparation and modeling of foundry, sand cleaning and sand blasting of castings and welding operations; mining, crushing, grinding, screening and mixing of refractory materials, glass, cement and stone production; mining, transportation and weaving of asbestos; tunneling and blasting, etc. The cause of pneumoconiosis is the inhalation of dust that causes pneumoconiosis, most of which is less than 2μm in diameter. At the beginning of exposure to dust, most of the dust that enters the alveoli is engulfed by phagocytes in the lungs and excreted through the mucous cilia excretion system, and only a portion of the dust is deposited in the alveoli, but with the passage of time, the mucous cilia system is destroyed, and more and more dust is deposited in the lungs. The dust in the alveoli can be carried into the alveolar septum by phagocytes, and the longer the time, the more dust enters the alveolar septum and reaches the lungs and other tissues of the body through the lymphatic or blood circulation, causing pathophysiological effects. Dust entering the lung can lead to autolysis of phagocytes through its physicochemical properties, thus causing local inflammatory reactions and fibrosis of lung tissue. In addition to dust foci and foci of dust cells (dust-eating macrophages), foci of fibroblasts and foci of fibers, the so-called silica nodules, can be formed in the lung tissue. The continuous expansion and fusion of silica nodules can form mass-like lesions, i.e., silicosis plaques, and accompanied by the proliferation of large amounts of fibrous tissue, which can destroy lung tissue and form pulmonary blisters and emphysema. In addition, the dust deposited in the airway can also damage the airway and destroy its mucus drainage system, thus making it difficult to expel dust from the alveoli and accelerating the deposition of dust in the lungs. Clinical manifestations Pneumoconiosis has a slow onset, with an incubation period of 5 to 10 years, with no obvious symptoms in the early stages and four main symptoms of coughing, coughing, chest pain and breathing difficulties in the middle and late stages. Early stages of pneumoconiosis (stages 0 and I) are mostly asymptomatic or have only very mild symptoms, and are often detected only during health examinations. As the disease progresses, symptoms such as cough and dyspnea gradually worsen. Dyspnea is the most common and earliest symptom, and is related to the severity of the disease. In mild cases, shortness of breath is often felt during heavy work, while in severe cases, shortness of breath is felt even at rest. In the early stage of pneumoconiosis, the cough is not obvious, but as the disease progresses, the patient often has a combination of chronic bronchitis and lung infection, which can make the cough significantly worse, accompanied by coughing sputum. Late stage pneumoconiosis is often accompanied by fatigue, wasting and loss of appetite. Common complications in pneumoconiosis patients include tuberculosis, lung infections, chronic obstructive pulmonary disease, pulmonary maculopathy, pulmonary heart disease, spontaneous pneumothorax, and other diseases, and as the disease worsens, the more likely the complications will appear. Patients with advanced pneumoconiosis can be completely incapacitated and unable to take care of themselves, which can eventually endanger their lives. V. Diagnosis A diagnosis can be made based on medical history (history of dust inhalation), respiratory symptoms, chest X-ray or chest CT imaging features, and exclusion of other diseases of the lung. According to chest X-rays, pneumoconiosis can be divided into four stages, with the code “0”, “I”, “II” and “III” (1) Stage 0. ①Stage 0. 0: normal chest X-ray performance; O+: X-ray performance is not enough for the diagnosis of “I”. ②Stage I. I: small circular shadows of grade 1 density with a distribution range of at least one in each of the two lung areas, each with a diameter greater than 2 cm; or small irregular shadows of grade 1 density with a distribution range of not less than two lung areas; I+: a significant increase in small shadows, but one of the densities and distribution ranges is not enough for the diagnosis of “II”. I+: a significant increase in the number of small shadows, but one of them is not enough to be classified as “II”. (8) Stage II. Ⅱ: small round or irregular shadows of grade 2 intensity with a distribution range of more than 4 lung areas; Ⅱ+: small shadows of grade 3 intensity with a distribution range of more than 4 lung areas, or large shadows that are not enough for “Ⅲ”. ④Three stages. Ⅲ: there are large shadows appearing, whose length diameter is ≥2cm and width diameter is ≥lcm; Ⅲ+: there is a single large shadow or multiple large shadows, and the sum of area exceeds the area of the right upper lung area. VI. Treatment Commonly used drugs for the treatment of silicosis include cisplatin, piperaquine phosphate, aluminum citrate and hanfanganine, which can improve patients’ symptoms and slow down the development of the disease, but their effects are limited. To date, there is no specific drug that can cure pneumoconiosis at home and abroad. However, it has been proven in practice that early and timely high volume total lung lavage can stop or slow down the development of pneumoconiosis. Large volume total lung lavage is a treatment for the presence of dust and alveolitis in the patient’s lungs. By instilling sterile physiological saline into the lungs, followed by negative pressure aspiration, the dust, macrophages and inflammatory and fibrosis-causing factors can be washed out of the alveoli due to the flushing of water, and it can also improve the symptoms and lung function, which is a therapy to eliminate the cause of the disease, which cannot be achieved by any drug. A large number of studies have shown that large volume whole lung lavage is safe, reliable and effective, but the effect of large volume whole lung lavage treatment is mainly related to the course of pneumoconiosis. (stage II-III), a large amount of dust has been transferred to the alveolar septum, and the lung tissue structure is destroyed, making treatment very difficult, and high-volume whole-lung lavage cannot wash out the dust in the alveolar septum, making treatment poor and expensive. In addition, advanced pneumoconiosis often cannot tolerate high volume total lung lavage treatment due to complications or poor lung function. In principle, pneumoconiosis patients should not be exposed to dust after large-capacity whole-lung lavage, and if they are exposed to dust again, they should undergo large-capacity whole-lung lavage again after 3 to 5 years to remove residual dust in the lungs and consolidate the therapeutic effect. Prevention Anyone engaged in pneumoconiosis-related occupations should do a good job of personal protection, wear dust-proof protective gear, and have regular health checkups. As soon as pneumoconiosis is identified, they should be immediately transferred from dust operations and removed from dust exposure. Patients with advanced pneumoconiosis should undergo comprehensive treatment. In addition to medication, they should develop good lifestyle habits, including adequate sleep and rest, regular living, quitting smoking and drinking, moderate physical exercise, and better nutrition, with more high-protein foods and vitamin-rich fruits. In conclusion, pneumoconiosis is the most serious occupational disease that endangers the health of workers in China, and there is a lack of effective treatment in the late stage. However, its therapeutic effect is closely related to the stage of pneumoconiosis, and early treatment can lead to the purpose of radical cure. Therefore, it is recommended that workers who have been exposed to dust for 3-5 years should be treated with large volume total lung lavage in a timely manner to avoid delaying the best time for treatment.