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Clinical Overview, Appendix A: Occupational Bronchiolitis						Print
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										Clinical OverviewAppendix AAirway Diseases
Occupational Bronchiolitis
Small airways of less than 2 mm in diameter – both membranous and respiratory bronchioles – may be affected by workplace inhalational exposures. The pathogenesis of occupational bronchiolitis likely involves injury to the bronchiolar epithelium, followed by excessive proliferation of granulation tissue during the repair process. This leads to concentric narrowing (constrictive bronchiolitis) or obliteration (obliterative bronchiolitis) of the airway lumen. Acute, high-dose inhalational exposures to a number of toxic workplace agents — classically the oxides of nitrogen and sulfur — are associated with acute or sub-acute obliterative bronchiolitis, often with organizing pneumonia. More insidious onset of work-related bronchiolitis has been linked with exposure to diacetyl and other chemicals used in the manufacture of artificial flavorings. Workers producing microwave popcorn as well as flavor production and upstream flavor chemical manufacturing workers may be at risk [Centers for Disease Control and Prevention 2007]. Military personnel deployed to Iraq and Afghanistan may develop sub-acute bronchiolitis, though the causal agent or agents is uncertain [King et al. 2011]. Fiberglass boat builders working with styrene and other chemicals used in glass-reinforced plastics may develop rapidly progressive obliterative bronchiolitis [Cullinan et al 2013]. Diagnosis of occupational bronchiolitis requires a high index of suspicion, as clinical findings are often nonspecific. A work-related pattern of respiratory symptoms is generally lacking in the sub-acute and chronic forms. As with emphysema, accelerated decline in FEV1 may be seen, often with an elevated residual lung volume and normal diffusion capacity.EMPHYSEMA & CHRONIC BRONCHITISPage 3 of 3REFERENCES
							
					
							Last Reviewed:  April 26, 2023						Source: 	National Institute for Occupational Safety and Health
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        Syndicate homeStudy Syllabus for Classification of Radiographs of Pneumoconioses
Introductionplus icon
Preface
Appreciation to Contributors
Intent of the Self-study Syllbus
Getting Started
Clinical Overviewplus icon
Major Occupational Lung Diseasesplus icon
Pneumoconioses
Central Role of Diagnostic Imagingplus icon
Role of CT
Overview of Nonimaging Clinical Tools in Lung Disease Diagnosis
Appendix A
References
Pathology Overviewplus icon
Pulmonary Silicosis
Coal Workers’ Pneumoconiosis
Asbestos Pleuropulmonary Disease
Pathological-Clinical Correlations
References
Radiograph Classificationplus icon
SUBSET 1 – Radiograph Classification, #1 to #19plus icon
Introduction
Radiograph Identification
Section 1: Image Quality
Section 2: Parenchymal Abnormalities, #1 to #14
Section 3: Pleural Abnormalities, #15 to #19
Section 4: Any Other Abnormalities
Section 5
SUBSET 2 – Radiograph #20 to #27plus icon
Radiograph #20
Radiograph #21
Radiograph #22
Radiograph #23
Radiograph #24
Radiographs #25 to #27
SUBSET 3 – Radiograph #28 to #38plus icon
Radiographs #28 to #30
Radiographs #31 to #32
Radiographs #33 to #35
Radiographs #36 to #38
SUBSET 4 – Radiograph #39 to #46 (Small and Large Opacities)plus icon
Radiographs #39 to #40
Radiographs #41 to #42
Radiographs #43 to #44
Radiograph #45
Radiograph #46
SUBSET 5 – Classifications and Answer Keys, Radiographs #47 to #83
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