Pneumoconiosis diagnostic criteria

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dushka Riaz, MD


The initial imaging done for pneumoconiosis is a chest x-ray. This serves as a screening test. High-resolution CT follows and is more sensitive and specific. HRCT can identify those diseases missed by chest radiograph. Pathognomonic for asbestosis is pleural thickening with pleural plaques. Silicosis would show round opacities in the upper lung. Massive fibrosis can be seen in both coal worker's pneumoconiosis and silicosis. [1] [2] [3] [4]

Diagnostic Study of Choice

Study of choice

Asbestosis with pleural plaques - Case courtesy of Dr Hani Makky Al Salam, <a href=""></a>. From the case <a href="">rID: 45002</a>

1. Radiologic tests must be performed to test for asbestosis when:

  • The patient has had exposure to asbestos (with Helsinki criteria indicating the dose being at least 25 fibre/ml.years)
  • The CT scan would show pulmonary fibrosis, pleural thickening and pleural plaques. [5] [6]

2. The best test for silicosis is a high resolution CT:

3. Coal worker's pneumoconiosis also presents similarly to silicosis on HRCT:

4. Berylliosis cases should have testing completed as well:

Diagnostic Criteria

To be qualified as a pneumoconiosis or occupational disease there must be four criteria met:


  1. Remy-Jardin M, Remy J, Farre I, Marquette CH (1992). "Computed tomographic evaluation of silicosis and coal workers' pneumoconiosis". Radiol Clin North Am. 30 (6): 1155–76. PMID 1410306.
  2. Akira M, Yokoyama K, Yamamoto S, Higashihara T, Morinaga K, Kita N; et al. (1991). "Early asbestosis: evaluation with high-resolution CT". Radiology. 178 (2): 409–16. doi:10.1148/radiology.178.2.1987601. PMID 1987601.
  3. Copley SJ, Wells AU, Sivakumaran P, Rubens MB, Lee YC, Desai SR; et al. (2003). "Asbestosis and idiopathic pulmonary fibrosis: comparison of thin-section CT features". Radiology. 229 (3): 731–6. doi:10.1148/radiol.2293020668. PMID 14576443.
  4. Walkoff L, Hobbs S (2020). "Chest Imaging in the Diagnosis of Occupational Lung Diseases". Clin Chest Med. 41 (4): 581–603. doi:10.1016/j.ccm.2020.08.007. PMID 33153681 Check |pmid= value (help).
  5. Darnton A, Hodgson J, Benson P, Coggon D (2012). "Mortality from asbestosis and mesothelioma in Britain by birth cohort". Occup Med (Lond). 62 (7): 549–52. doi:10.1093/occmed/kqs119. PMC 3471357. PMID 23034792.
  6. "Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution". Scand J Work Environ Health. 23 (4): 311–6. 1997. PMID 9322824.
  7. Cullinan P, Reid P (2013). "Pneumoconiosis". Prim Care Respir J. 22 (2): 249–52. doi:10.4104/pcrj.2013.00055. PMC 6442808. PMID 23708110.
  8. Remy-Jardin M, Degreef JM, Beuscart R, Voisin C, Remy J (1990). "Coal worker's pneumoconiosis: CT assessment in exposed workers and correlation with radiographic findings". Radiology. 177 (2): 363–71. doi:10.1148/radiology.177.2.2217770. PMID 2217770.
  9. Balmes JR, Abraham JL, Dweik RA, Fireman E, Fontenot AP, Maier LA; et al. (2014). "An official American Thoracic Society statement: diagnosis and management of beryllium sensitivity and chronic beryllium disease". Am J Respir Crit Care Med. 190 (10): e34–59. doi:10.1164/rccm.201409-1722ST. PMID 25398119.
  10. Maier LA (2002). "Clinical approach to chronic beryllium disease and other nonpneumoconiotic interstitial lung diseases". J Thorac Imaging. 17 (4): 273–84. doi:10.1097/00005382-200210000-00004. PMID 12362066.
  11. Sharma N, Patel J, Mohammed TL (2010). "Chronic beryllium disease: computed tomographic findings". J Comput Assist Tomogr. 34 (6): 945–8. doi:10.1097/RCT.0b013e3181ef214e. PMID 21084914.
  12. Epler GR (1992). "Clinical overview of occupational lung disease". Radiol Clin North Am. 30 (6): 1121–33. PMID 1410303.

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