Which investigations are recommended to confirm a diagnosis of pneumoconiosis in primary care?

Recommended investigations to confirm a diagnosis of pneumoconiosis in primary care include:

• Chest X-ray: This is the initial imaging investigation to identify lung abnormalities consistent with pneumoconiosis and to exclude other pathologies. It is routinely recommended at the time of initial respiratory evaluation ¹.
• Detailed occupational and exposure history: Essential to identify relevant environmental or occupational risk factors associated with pneumoconiosis ².
• Spirometry: To assess lung function and identify any obstructive or restrictive patterns, although spirometry alone cannot confirm pneumoconiosis, it supports the clinical assessment ¹.
• Referral for high-resolution CT (HRCT) scan: If chest X-ray findings are inconclusive or to further characterize lung abnormalities, HRCT is recommended, typically via specialist referral rather than primary care ².
• Blood tests and other investigations: While not diagnostic for pneumoconiosis, blood tests may be used to exclude alternative diagnoses or comorbidities ².

In primary care, the key investigations are chest X-ray and spirometry combined with a thorough history. Confirmation and further detailed imaging (HRCT) are usually performed in secondary care settings ¹,².