A person works in a silicone manufacturing industry for thee past 20 years. Since a few years he has stated feeling quite breathless and has cough all the time . His doctor says that this is because of his occupation as he is exposed constantly to silica dust . What must have been the size of the particles to cause such an issue ?
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Answer:
A 43-year-old man was admitted to the Guangzhou Institute of Respiratory Disease (GIRD), the First Affiliated Hospital of Guangzhou Medical University because of recurrent episodes of coughing, expectoration and wheezing for 3 years with aggravation during the previous 6 months.
The patient began to cough with white phlegm after a cold in 2012. The cough was worse upon waking in the morning and laying down at night. He had no chills, fever, chest pain, chest tightness, palpitations, night sweats, hemoptysis or paroxysmal nocturnal dyspnea. He was diagnosed with ‘upper respiratory infection’ in a local hospital and received symptomatic treatment for several days that he could not recall clearly. His condition improved, but he still had occasional relapses. One month after the treatment, he suffered from an attack of wheezing during moderate activity and was admitted to a local hospital, in which he was diagnosed with ‘bronchial asthma’ and ‘type 2 respiratory failure’, from 1st December to 13th December 2012. Chest CT scan showed interstitial inflammation in the right middle and left upper lobe. Pulmonary function test suggested mild obstructive ventilatory dysfunction with FEV1 at 72.2% of predicted, FVC at 89.7% of predicted, and FEV1/FVC ratio at 66.81%. The bronchodilator reversibility test was positive: FEV1 increased >12% and >200 mL with inhaled Ventolin 400 µg (Figure 1). No abnormalities were noted in echocardiogram. Inflammation was observed in both bronchial trees on bronchoscopy. After receiving symptomatic treatment, the patient’s condition improved but did not normalize. Upon referral, he was admitted to our hospital for further treatment. The treatment included Methylprednisolone at a daily dose of 40 mg intravenously and oral Theophylline 0.2 g once every 12 hours for 3 days. After that, his condition improved and he was subsequently discharged
Answer:
PM 2.5
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