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La silicosis pulmonar es una enfermedad ocupacional que continúa ocasionando morbilidad en el mundo. Debido a que el sílice es el mineral más abundante en la tierra y en las rocas, son numerosas las fuentes de exposición laboral a la inhalación del polvo de sílice en varios sectores industriales. Por su parte, la silicoproteinosis pulmonar es una forma aguda muy rara de silicosis, que puede desarrollarse con un período de latencia más corto en comparación con la silicosis, luego de la primera exposición al sílice, y se caracteriza por un rápido deterioro de la función pulmonar, sin respuesta efectiva a ningún tratamiento. Por su forma de presentación tan atípica, reportamos el caso de un hombre de 58 años, con antecedente laboral de trabajo en mina de extracción de oro en socavón

Pulmonary silicosis is an occupational disease that continues to cause morbidity in the world. Because silica is the most abundant mineral in soil and rock, sources of occupational exposure to inhalation of silica dust are numerous in various industrial sectors. Alternately, pulmonary silicoproteinosis is a very rare acute form of silicosis, which can develop with a shorter latency period compared to silicosis after the first exposure to silica, and is characterized by a rapid deterioration of lung function, without effective response to any treatment. Due to its atypical form of presentation, we report the case of a 58-year-old man, with a history of working in a gold mine

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BACKGROUND: Pneumoconiosis is a lung disease related to exposure to dust in the workplace. The disease can induce irreversible damage to health, especially in lung tissue, and can cause progressive and permanent physical disabilities. AIMS: This study evaluated the temporal and spatial distribution of mortality rates (1979-2019) and hospital admissions (1995-2019) for pneumoconiosis in Brazil. METHODS: The outcomes were hospitalization and death due to pneumoconiosis: codes 500-506 according to the ICD-9 and J60-J66 according to the ICD-10. Data from this retrospective ecological study were collected from the Brazilian Ministry of Health database. RESULTS: Hospitalization for pneumoconiosis has decreased in all regions of Brazil. Hospitalizations occurred predominantly in men aged over 40 years. Death rates showed a temporal increase in all regions. Deaths occurred predominantly in men aged over 50 years. The highest hospitalization and death rates were in the states of the Midwest and South Regions. CONCLUSIONS: Pneumoconiosis is a preventable occupational disease, and ongoing occurrences of hospitalizations and deaths highlight the importance of inspecting industries and controlling occupational and environmental exposures.

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Small pneumoconiotic opacities in coal miners are usually described as rounded, regular, and upper zone predominant. We aim to characterize chest radiographic patterns in New Mexico coal miners in comparison with other miners. Of the 330 chest radiographs reviewed, small pneumoconiotic opacities in New Mexico miners were almost always irregularly shaped, and lower lung zone predominant, consistent with diffuse dust-related pulmonary fibrosis. There was no significant difference in patterns of opacities between miners with exposure to coal mine dust exclusively, mixed coal and noncoal mine dust, and no coal dust. Our findings indicate that New Mexico coal miners demonstrate a different pattern of small pneumoconiotic opacities than the classic nodular pneumoconiosis described in the literature, predominantly from Appalachian miners. This may indicate differences in racial/ethnic characteristics or in the silica/silicate content of dust between the Appalachian and Mountain West regions.

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Mixed pneumoconiosis is a pulmonary disease associated with several inhaled mineral irritants. Dust was found in the alveolar macrophages, alveolar and bronchial walls and pulmonary interstitial tissue of two female coyotes (Canis latrans). The dust contained large amounts of silica, coal, iron and copper particles, which were associated with severe pulmonary disease. Lung injury in the animals was characterized by pulmonary nodules, severe interstitial fibrosis, alveolar hyperplasia and bone formation within alveolar spaces. Coyotes inhaled mineral dust while roaming a field close to three mineral extraction zones. To our knowledge, this is the first report of the concomitant inhalation of multiple minerals in association with diffuse pulmonary ossification in the pulmonary parenchyma of two wild canine animals.

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RESUMEN La neumoconiosis es una enfermedad, con características radiológicas similares a la silicosis, que afecta a los trabajadores dedicados al trasporte de carbón que se exponen durante los procesos de extracción y depósito de polvo de carbón en las centrales térmicas, la industria siderúrgica, la industria química e incluso en la venta y uso de equipos electrodomésticos. Se presenta un paciente de 65 años, con antecedentes de reiterados ingresos por neumonía extra hospitalaria, que presentaba falta de aire después de realizar cualquier esfuerzo físico. La tomografía de tórax confirmó que el paciente había sufrido una exposición prolongada al humo del carbón. Se diagnosticó la presencia de un fibroenfisema bulloso y adenopatías mediastinales. La prevención es la medida más eficaz para la lucha contra esta enfermedad. Se debe implementar el estricto cumplimiento de las medidas técnicas y la vigilancia constante de los niveles de polvo permitidos.

ABSTRACT Pneumoconiosis is a disease, with radiological characteristics similar to silicosis, which affects coal workers during coal dust deposition and extraction in thermal power plants, steel and chemical industry, and even in the sale and use of household appliances. We present a 65-year-old patient with a history of recurrent admissions for community-acquired pneumonia who had shortness of breath on exertion. Chest computed tomography confirmed that the patient had suffered a prolonged exposure to charcoal smoke. The presence of bullous fibroemphysema and mediastinal adenopathies was diagnosed. Prevention is the most effective measure to fight this disease. Strict compliance with technical measures and constant monitoring of permitted dust levels should be implemented.

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Objetivo: avaliar a prevalência dos sintomas respiratórios ocupacionais, pico de fluxo expiratório (PFE) e fatores associados em trabalhadores de uma indústria de cerâmica do sul do Brasil. Métodos: estudo transversal. Foram avaliados trabalhadores de uma indústria de cerâmica do Sul do Brasil. Como instrumentos de pesquisa, foram aplicados questionários relacionados a aspectos ocupacionais, sintomas respiratórios, hábitos tabágicos e medida do PFE. As variáveis sociodemográficas e ocupacionais foram comparadas com os sintomas respiratórios e PFE. Resultados: foram avaliados 151 trabalhadores, sendo, predominantemente, do sexo masculino (87,4%), com média (±DP) de idade de 30,4 (±8,4) anos e histórico de tabagismo em 23,8% dos participantes. Entre os sintomas respiratórios, 23% relataram tosse diária e noturna e dispneia, 21% confirmaram escarro durante o dia/noite, e apenas 7% referiram chiado ou sibilos. O PFE abaixo de 80% do previsto foi encontrado em 37,1% dos trabalhadores, com média (±DP) de 84(±16,7)%. Ao comparar os fatores ocupacionais com os desfechos, foi observado que o menor tempo de trabalho esteve relacionado à maior prevalência de tosse (p=0,024). Conclusão: os sintomas respiratórios mais prevalentes foram a tosse e a dispneia, seguidos por escarro e sibilância. Aproximadamente, 1/3 dos trabalhadores demonstraram PFE<80%. Contudo, a relação inversa entre tempo de trabalho e sintomas merece maior investigação.

Objective: To evaluate the prevalence of occupational respiratory symptoms, peak expiratory flow (PEF) and associated factors in workers from a ceramic industry in southern Brazil. Methods: Cross-sectional study. Workers from a ceramic industry in southern Brazil were evaluated. The research instruments were questionnaires related to occupational aspects, respiratory symptoms, smoking habits, and PEF measurements. Sociodemographic and occupational variables were compared with respiratory symptoms and PEF. Results: We evaluated 151 workers, predominantly male (87.4%), with a mean (±DP) age of 30.4 (±8.4) years and a history of smoking in 23.8% of participants. Among the respiratory symptoms, 23% reported daily and nocturnal cough and dyspnea, 21% confirmed sputum during the day / night, and only 7% reported wheezing. PEF below 80% of predicted was found in 37.1% of workers, with a mean (± DP) of 84 (± 16.7) %. When comparing the occupational factors with outcomes, it was observed that the shorter working time was related to higher cough prevalence (p=0.024). Conclusion: The most prevalent respiratory symptoms were coughing and dyspnea, followed by sputum and wheezing. Approximately 1/3 of workers showed PEF <80%. However, the inverse relationship between working time and symptoms merits further investigation.

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Resumen Se describen 21 casos con hallazgo incidental de várices esofágicas superiores (Downhill varices) en endoscopia de las vías digestivas altas. Además, se detallan algunos datos relevantes de la historia clínica y de los hallazgos endoscópicos. La relación hombres/mujeres fue 1:1 y la edad promedio fue de 67,9 años. La comorbilidad más frecuente fue la enfermedad pulmonar obstructiva crónica (EPOC), seguida de las neumoconiosis, la obesidad y el síndrome de apnea-hipopnea, todas con hipertensión pulmonar (HTP) asociada. Las tres últimas causas no han sido descritas previamente en la literatura sobre várices esofágicas superiores. Ningún paciente tenía antecedente de hemorragia variceal.

Abstract We describe 21 cases with incidental endoscopic findings of upper esophageal varices (downhill varices) and relevant data from patients' clinical histories and endoscopic findings. The male/female ratio was 1:1 and patients' average age was 67.9 years. The most frequent comorbidity was chronic obstructive pulmonary disease, followed by pneumoconiosis, obesity and apnea-hypopnea syndrome. All comorbidities had associated pulmonary hypertension. The last three causes have not been previously described in the literature on upper esophageal varices. None of the patients had histories of variceal hemorrhaging.

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Para el diagnóstico certero de fibrosis pulmonar idiopática (FPI) es de vital importancia la presencia de un patrón tomográfico definitivo de neumonía intersticial usual (NIU), en un contexto clínico adecuado. El interrogatorio dirigido, el uso de cuestionarios validados, una evaluación reumatológica acuciosa y exámenes complementarios son importantes para descartar causas secundarias de fibrosis pulmonar como neumonitis por hipersensibilidad (NHS), enfermedades del tejido conectivo (ETC), toxicidad por drogas y algunas neumoconiosis que pueden imitar el patrón radiológico y muchas veces dificultar un diagnóstico adecuado de FPI.

For the accurate diagnosis of idiopathic pulmonary fibrosis (IPF), the presence of a definitive tomographic pattern of usual interstitial pneumonia (UIP) is of vital importance, in an appropriate clinical context. Targeted interrogation, the use of valid questionnaires, an acute rheumatologic evaluation and complementary examinations are important to rule out secondary causes such as hypersensitivity pneumonitis (HP), connective tissue diseases (CTD), drug toxicity and some pneumoconiosis that can mimic the radiological pattern and often hinder a clear diagnosis of IPF.

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