Conn's current therapy 1994. Conn HF, Rakel RE, ed. Philadelphia, PA: W. B. Saunders, 1994 Jan; :207-210
The occupational risks, pathogenic mechanism, clinical manifestation, prevention and treatment of silicosis were reviewed and discussed. Alveolar macrophage interactions with inhaled silica (14808607) particles and subsequent formation of hyaline nodules were described. The increased reactivity of freshly fractured silica was mentioned. Chronic, complicated, accelerated and acute silicosis were described in terms of clinical symptoms, time from exposure to onset, and complications. The importance of prevention was emphasized in light of the limitations of current therapies. The need to report cases of silicosis was stressed as a means to protect other workers. Treatment of silicosis has mainly involved treating the complications associated with the condition. Treatment of airway obstruction with beta-2 adrenergic agents and theophylline was suggested. Aggressive antibiotic therapy with pathogen culturing and resistance assays for bronchial infections, including tuberculosis, was recommended. Hydration, humidification, postural drainage and particularly the cessation of smoking were recommended to reduce airway secretions. Supplemental oxygen was recommended in the treatment of hypoxemia. The use of whole lung lavage, glucocorticoid therapy and prednisone in acute silicosis was discussed. The seriousness of silicosis was underscored by the possible need for lung or heart/lung transplants in end stage silicosis. The author concludes that silica exposure prevention is critically important due to the lack of successful therapy for silicosis.