Fuller’s Earth Pneumoconiosis - An Overview

What Is Pneumoconiosis?

Pneumoconiosis, also called black lung disease, can be defined as a group of lung disorders caused by excessive inhalation of certain dust particles. These infections are most common among the workers of a particular industry rather than the environment's causative factor.

What Are the Types of Pneumoconiosis?

• Asbestosis: A lung disorder or fibrosis of the lung caused due to prolonged exposure to asbestos and fibers.

• Silicosis: Lung fibrosis resulting from frequent exposure to silica particles.

• Coal Workers Pneumoconiosis: A lung disease commonly seen amongst coal mine workers or in females who cook on fire ignited with coal for years.

• Fuller's Earth Pneumoconiosis: A lung disease similar to pneumoconiosis that develops due to chronic exposure to calcium montmorillonite, a mineral substance.

What Is Fuller Earth?

Fuller's earth is a mineral or a porous colloidal clay mainly composed of calcium montmorillonite, a hydrated aluminum silicate. Montmorillonite is an aluminum silicate with the chemical formula (Al, Fe, Mg)4Si8O20(0H)4, in which the amounts of aluminum, iron, and magnesium are not fixed. Calcium montmorillonite is formed primarily by the natural decomposition of rocks in the water or from volcanic ash and is found in various parts of the world. It is clay-like in appearance, with the texture being more fine-grained with comparatively more water content. This material is obtained in multiple colors ranging from orange to green.

Who Is at Risk of Developing Fuller’s Earth Pneumoconiosis?

Fuller’s earth pneumoconiosis is seen in people whose work is related to the mining and processing of some substances, such as:

• Aluminum silicate.

• Calcium silicate.

• Zirconium silicate.

• Fuller’s earth.

• Kaolin.

• Zeolite.

• Pyrophylite.

What Are the Uses of Fuller’s Earth?

Fuller earth was conventionally used as a bleaching agent and dye for clothes; recently, it has been recognized and used in various industries like cosmetics as base products, powders, and lubricating and molding oils. The use of montmorillonite is gaining popularity throughout the world these days, thus increasing the risk of exposure disorder for industrial workers.

What Is Fuller Earth Pneumoconiosis?

Fuller earth pneumoconiosis is a lung infection caused by prolonged exposure to calcium montmorillonite without quartz. It affects the lungs and is developed through prolonged exposure.

What Are the Causes of Fuller’s Earth Pneumoconiosis?

• Repeated exposure to fuller earth dust.

• Absorption of fuller earth metal through the skin or oral consumption.

• Poisoning or toxicity due to calcium montmorillonite.

How Is Pneumoconiosis Diagnosed?

• Chest X-ray: Chest X-ray shows military mottling of the lungs.

• CT Scan: CT scan (Computed tomographic scan) shows presence of ground glass opacities.

• Microscopic Examination: Characteristic microscopic examination reveals centrilobular interstitial brown dust-laden macrophages with fibrosis.

• Macroscopic Examination: Grey black stellate nodules are noted.

• Mineralogical Analysis: This is the method to confirm the causative agent for the disease, and this analysis is carried out in two ways:

X-ray Diffraction: This is done using the tissue sample obtained. Diagnosis is confirmed when crystalline particles resembling montmorillonite are found without traces of other minerals.

Analytical Transmission: This diagnostic test presents aggregates of microcrystalline materials structurally and chemically similar to montmorillonite; this finding helps confirm the diagnosis.

What Are the Symptoms of Pneumoconiosis?

The condition is generally mild and does not present with serious complications or medical emergencies.

Some of the common symptoms are as follows:

• Cough with sputum, which is green, yellow, or even bloody in color.

• Rapid breathing and shortness of breath.

• Chest pain that usually worsens when taking a deep breath.

• Tachycardia.

• Fever with chills.

• Feeling tired.

• Confusion or delirium, especially in older adults.

• Loss of appetite.

What Are the Preventive Measures for Fuller’s Earth Pneumoconiosis?

The disease is irreversible, and the region of the lungs affected once cannot be restored or repaired. Therefore, prevention is vital in cases of pneumoconiosis.

Some of the standard preventive measures include:

• Use a mask when handling the material.

• Washing areas that come in contact with dust immediately to prevent absorption through the skin.

• Safely remove dust from clothing and avoid reusing the same clothes without washing them.

• Wash and clean the body entirely without touching other objects in the house or having food or water.

• Avoid smoking.

• Keeping levels of dust minimal.

• Adequately ventilating a workspace.

• Regular medical checkups.

How Is Pneumoconiosis Treated?

Treatment mainly aims to control the emergency and prevent further damage to the lungs or the body. When present at the hospital, the patients mainly have the chief complaint of breathlessness; therefore, stabilizing the vitals and meeting the oxygen demands are the primary goals of treatment in the emergency department.

Therefore, treatment modalities include:

• Supplemental Oxygen Therapy: It is required in cases with severe hypoxia who present to the hospital in the later stages of the disease.

• Bronchodilators: These medications are prescribed to open the airways and prevent breathlessness. The mechanism of action of these drugs includes dilating the airway and facilitating more passage for the exchange of gasses.

• Corticosteroids: These are other medications used to overcome bronchial inflammation and ease breathing.

• Other medications:

1. Polyvinyl pyridine.

2. Tetrandrine.

3. Hydroxy piperaquine phosphate.

4. Aluminum citrate.

5. Xining.

6. Xifeining.

The medications mentioned above have proved to be effective in cases of pneumoconiosis.

The person who develops Fuller's earth pneumoconiosis is advised to stay away from the areas with potential exposure to the mineral.

Conclusion:

Fuller's earth pneumoconiosis is a rare type of pneumoconiosis caused as a result of frequent exposure to a mineral called calcium montmorillonite, and this disease is most common amongst industrial workers who are exposed every day to the dust of this mineral; these patients present with the symptoms of shortness of breath, dizziness, or chest pain.

The disease is irreversible but less severe as it does not present with many emergencies. In emergencies, a patient's most common complaint is shortness of breath; thus, emergency cases require supplemental oxygen therapy and steroids to stabilize the condition. As the disease is avoidable but irreversible, preventive measures are most important.

As the condition develops on prolonged exposure, it can be prevented or diagnosed early by conducting frequent medical examinations and using adequate protective measures.