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Occupational COPD in construction dust exposure — DOccMed MCQ

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HardOccupational Lung DiseaseOccupational COPD in construction dust exposureDOccMed

A 61-year-old demolition worker with a 15 pack-year smoking history has chronic cough and exertional dyspnoea. Spirometry shows fixed obstruction; he spent 30 years breaking concrete indoors without effective dust control and has no bronchodilator variability. What is the most likely occupational diagnosis?

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Correct answer: E — Chronic obstructive pulmonary disease with occupational dust contribution

Fixed airflow obstruction with chronic symptoms is consistent with COPD. The occupational history of long-term construction dust exposure may have contributed alongside smoking. Silicosis can coexist but typically shows radiological nodularity and restriction or mixed changes rather than isolated obstruction. Occupational asthma would show greater variability and work-related reversibility.

Reference: HSE Construction dust guidance; NICE COPD guidance