title: Proposed criteria for mixed-dust pneumoconiosis: definition, descriptions, and guidelines for pathologic diagnosis and clinical correlation.
abstract: We defined mixed-dust pneumoconiosis (MDP) pathologically as a pneumoconiosis showing dust macules or mixed-dust fibrotic nodules (MDF), with or without silicotic nodules (SN), in an individual with a history of exposure to mixed dust. We defined the latter arbitrarily as a mixture of crystalline silica and nonfibrous silicates. According to our definition of MDP, therefore, MDF should outnumber SN in the lung to make a pathologic diagnosis of MDP. In the absence of confirmation of exposure, mineralogic analyses can be used to support the pathologic diagnosis. The clinical diagnosis of MDP requires the exclusion of other well-defined pneumoconioses, including asbestosis, coal workers' pneumoconiosis, silicosis, hematite miners' pneumoconiosis, welders' pneumoconiosis, berylliosis, hard metal disease, silicate pneumoconiosis, diatomaceous earth pneumoconiosis, carborundum pneumoconiosis, and corundum pneumoconiosis. Typical occupations associated with the diagnosis of MDP include metal miners, quarry workers, foundry workers, pottery and ceramics workers, and stonemasons. Irregular opacities are the major radiographic findings in MDP (ILO 1980), in contrast to silicosis, in which small rounded opacities predominate. Clinical symptoms of MDP are nonspecific. MDP must be distinguished from a variety of nonoccupational interstitial pulmonary disorders.
authors.affiliation: Department of Pathology, Dokkyo University School of Medicine, Mibu, Tochigi, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Honma
authors.forename: Jerrold L
authors.initials: JL
authors.lastname: Abraham
authors.forename: Keizo
authors.initials: K
authors.lastname: Chiyotani
authors.forename: Paul
authors.initials: P
authors.lastname: De Vuyst
authors.forename: Pascal
authors.initials: P
authors.lastname: Dumortier
authors.forename: Allen R
authors.initials: AR
authors.lastname: Gibbs
authors.forename: Francis H Y
authors.initials: FH
authors.lastname: Green
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hosoda
authors.forename: Kazuro
authors.initials: K
authors.lastname: Iwai
authors.forename: William Jones
authors.initials: WJ
authors.lastname: Williams
authors.forename: Norihiko
authors.initials: N
authors.lastname: Kohyama
authors.forename: Gaston
authors.initials: G
authors.lastname: Ostiguy
authors.forename: Victor L
authors.initials: VL
authors.lastname: Roggli
authors.forename: Hisao
authors.initials: H
authors.lastname: Shida
authors.forename: Osamu
authors.initials: O
authors.lastname: Taguchi
authors.forename: Val
authors.initials: V
authors.lastname: Vallyathan
mesh_terms: D004391:Dust; D006801:Humans; D007391:International Cooperation; D008168:Lung / Q000473:pathology*; D008903:Minerals; D016273:Occupational Exposure / Q000009:adverse effects; D011009:Pneumoconiosis / Q000145:classification / Q000209:etiology / Q000473:pathology*; D017410:Practice Guidelines as Topic; D012822:Silicon Dioxide / Q000009:adverse effects
chemical_list: D004391:Dust; D008903:Minerals; D012822:Silicon Dioxide