Occupational Health

Which finding best distinguishes asbestosis from silicosis in a 60-year-old Indian construction worker with occupational lung disease and bilateral lung fibrosis on high-resolution CT?

A 38-year-old male worker in a textile mill presents to the occupational health clinic with a 6-month history of progressive dyspnea, dry cough, and chest tightness. He has been working in the carding and spinning department for 12 years. Chest X-ray shows bilateral lower lobe predominant reticular opacities. Spirometry reveals a restrictive pattern with FVC 65% predicted and FEV₁/FVC ratio 0.82. He denies smoking. What is the most appropriate next step in management?

A 42-year-old female worker in a leather tannery reports to the occupational health department with complaints of recurrent skin rashes, erythema, and vesiculation on her hands and forearms for 3 months. She works in the chrome tanning section. Patch testing is planned. Meanwhile, she continues to work in the same section without protective equipment. What is the most appropriate immediate next step?

Which of the following occupational exposures is most strongly associated with mesothelioma?

A 42-year-old male welder with 15 years of occupational exposure presents to the occupational health clinic for routine screening. He reports occasional mild dyspnea on exertion and a dry cough for 6 months. He denies fever, weight loss, or hemoptysis. On examination, breath sounds are normal. Chest X-ray shows bilateral upper lobe nodular opacities with fibrosis and mild hilar lymphadenopathy without calcification. Spirometry shows FEV₁ 72% predicted, FVC 78% predicted, and FEV₁/FVC ratio 0.92. High-resolution CT chest confirms centrilobular nodules in the upper lobes. What is the most appropriate next step in management?