What are the key clinical features to consider when diagnosing pneumoconiosis in a patient with occupational exposure to dust?

Key clinical features to consider when diagnosing pneumoconiosis in a patient with occupational dust exposure include:

• History of occupational exposure: A detailed occupational history identifying prolonged or intense exposure to dusts such as coal, silica, or asbestos is essential, as pneumoconiosis is directly related to inhalation of mineral dusts ¹ (Hua et al., 2023).
• Respiratory symptoms: Patients commonly present with progressive exertional dyspnoea and chronic cough, often without sputum production, reflecting the fibrotic lung changes ¹ (Kim et al., 2001).
• Physical examination findings: May reveal bibasal crackles on auscultation and, in advanced cases, signs of cor pulmonale such as peripheral oedema ¹ (Flors et al., 2010).
• Radiological features: Chest X-ray and high-resolution CT scans typically show small, rounded opacities or nodules predominantly in the upper lung zones for coal workers’ pneumoconiosis and silicosis, or pleural plaques and fibrosis in asbestosis ¹ (Kim et al., 2001; Flors et al., 2010).
• Pulmonary function tests: Usually demonstrate a restrictive pattern with reduced lung volumes and impaired gas transfer, consistent with interstitial fibrosis ¹ (Hua et al., 2023).
• Exclusion of other causes: It is important to exclude other interstitial lung diseases and malignancies, especially in patients with risk factors such as smoking ¹.

Integrating UK guideline recommendations with recent literature emphasizes the importance of combining clinical, occupational, radiological, and functional assessments to establish the diagnosis of pneumoconiosis accurately (Kim et al., 2001; Hua et al., 2023).