Miner's lung with<unk>  and tuberculosis. (Basque Museum of the History of Medicine and Science, Spain) Because chronic<unk>  is slow to develop, signs and symptoms may not appear until years after exposure. Signs and symptoms include: * Dyspnea (shortness of breath) exacerbated by exertion * Cough, often persistent and sometimes severe * Fatigue * Tachypnea (rapid breathing) which is often labored, * Loss of appetite and weight loss * Chest pain * Fever * Gradual darkening of skin (blue skin) * Gradual dark shallow rifts in nails eventually leading to cracks as protein fibers within nail beds are destroyed. In advanced cases, the following may also occur: * Cyanosis, pallor along upper parts of body (blue skin) * Cor pulmonale (right ventricle heart disease) * Respiratory insufficiency Patients with<unk>  are particularly susceptible to tuberculosis (TB) infection—known as silicotuberculosis. The reason for the increased risk—3 fold increased incidence—is not well understood. It is thought that silica damages pulmonary macrophages, inhibiting their ability to kill mycobacteria. Even workers with prolonged silica exposure, but without<unk> , are at a similarly increased risk for TB. Pulmonary complications of<unk>  also include chronic bronchitis and airflow limitation (indistinguishable from that caused by smoking), non-tuberculous Mycobacterium infection, fungal lung infection, compensatory emphysema, and pneumothorax. There are some data revealing an association between<unk>  and certain autoimmune diseases, including nephritis, scleroderma, and systemic lupus erythematosus, especially in acute or accelerated<unk> . In 1996, the International Agency for Research on Cancer (IARC) reviewed the medical data and classified crystalline silica as "carcinogenic to humans." The risk was best seen in cases with underlying<unk> , with relative risks for lung cancer of 2–4. Numerous subsequent studies have been published confirming this risk. In 2006, Pelucchi et al. concluded, "The<unk> -cancer association is now established, in agreement with other studies and meta-analysis."
Silicosis
Asbestosis
Coalworker's pneumoconiosis
Beryllium granuloma
Asbestos-related diseases
Occupational asthma
Pneumoconiosis
Organic dust toxic syndrome