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What is involved? (including coding of cases) SABRE Case Studies and Information
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2. Inhalation accidentsInhalation accidents are caused by a variety of agents, including various metallic compounds. Both the upper and lower respiratory tract may be involved. Which condition develops will depend upon the agent and the intensity of exposure, and may present as rhinitis, laryngitis, tracheobronchitis, chemical pneumonitis and non-cardiogenic pulmonary oedema (Elmes et al., 2000). Symptoms of inhalational injuries include watery eyes (lacrimation), sore throat, cough, chest pain. Severe cases may present with symptoms characteristic of adult respiratory distress syndrome (Elmes et al., 2000). Severe non-cardiogenic pulmonary oedema may develop in cases with deep lung exposures (Elmes et al., 2000). 3. Allergic alveolitis (Extrinsic)Extrinsic allergic alveolitis, also known as hypersensitivity pneumonitis, represents a group of diseases with an immunological basis and follows intense or repeated exposure to organic dusts (Salvaggio et al., 1998). The clinical picture and pathology tends to be similar irrespective of the origin of the inhaled dust. There are two forms of the disease, termed acute or chronic. Individuals with the acute form of the disease have episodes of fever, cough and breathlessness several hours after the exposure (Taylor, 2000). Individuals with the chronic form of the disease development irreversible pulmonary fibrosis. Examples of organic dusts include mouldy hay, bird excreta and mushroom spores (Taylor, 2000). Farmer's lung and Miller's lung are two examples of extrinsic allergic alveolitis. 5. Bronchitis and EmphysemaBronchitis is a condition in which increased mucus is secreted in the bronchi resulting in a productive cough, and is normally as a result of a severe cold. Chronic bronchitis is the recurrent and excess production of mucus for three months of a year over a two year period. Emphysema is characterised by varying degrees of destruction and dilation of the alveoli (Parkes, 1994). In combination, chronic bronchitis and emphysema comprise chronic obstructive pulmonary disease (COPD). 6. Infectious DiseasesOrnithosis- PsittacosisPsittacosis is caused by the bacterium Chlamydia psittaci and is the best known chlamydial pulmonary infection. This disease, which mainly affects birds of the parrot family, pigeons and turkeys, may be acquired by farmers and people keeping or handling birds or coming into contact with their droppings (Woodhead, 1994). Q-feverQ fever is caused by the rickettsia, Coxiella burnetti and is one of the most infectious agents known to humankind. The inhalation of a single organism is sufficient to establish infection. Q fever is nearly always acquired by animal contact either directly or indirectly (Woodhead, 1994). TuberculosisTuberculosis (TB) is a bacterial infection of the lungs caused by the bacterium Mycobacterium tuberculosis. Infection normally results in pneumonia, although, it may infect any part of the body. Two forms of infection exist, the first being the primary infection which is the most prevalent form in those infected with the bacterium. A small area of exudation in the lung parenchyma forms the primary lesion. The bodies natural defense mechanisms normally halt the spread of the bacterium, by enclosing the infection site in calcified tissue. Secondary tuberculosis develops when the body is reinfected with the bacterium, either by uncontrolled spread of the infection from the primary lesion or from external sources. Most cases are due to spread of the bacterium from previous sites of infection. TB has gained more publicity in recent times due to the development of multi-drug resistant strains. 7. OtherRhinitisRhinitis is characterised by inflammation of the mucous membranes of the nose. Rhinitis may be caused by many of the agents responsible for causing occupational asthma (Refer Occupational Asthma Section). ByssinosisByssinosis is a respiratory disease which occurs in workers who have been exposed to the dust from cotton or flax (Rylander, 1998). It is characterised by "Monday morning chest tightness" the symptoms of which tend to improve during the week. Patients may have non-specific bronchial hyperresponsiveness, although this is not required for the diagnosis. Continuing exposure may result in reduced lung function. References (for all summaries in this section)
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