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

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

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 .
  • Detailed occupational and exposure history: Essential to identify relevant environmental or occupational risk factors associated with pneumoconiosis .
  • Spirometry: To assess lung function and identify any obstructive or restrictive patterns, although spirometry alone cannot confirm pneumoconiosis, it supports the clinical assessment .
  • 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 .
  • Blood tests and other investigations: While not diagnostic for pneumoconiosis, blood tests may be used to exclude alternative diagnoses or comorbidities .

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 ,.

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