Macroscopic assessment of occupational lung diseases
| *0, absent; 1, slight degree of reticulin or collagen accumulation around respiratory bronchioles; 2, fibrosis around respiratory bronchioles extending into adjacent alveolar ducts, atria, and alveoli, but not extending to adjacent respiratory bronchioles; 3, fibrosis linking adjacent respiratory bronchioles; 4, widespread fibrosis with or without honeycombing. |
| Primary dust foci |
| Average size (grade 0 to 3) |
| 1, 1–3 mm; 2, 4–5 mm; 3 > 5 mm |
| Profusion (grade 0 to 3) |
| Assessed according to the proportion of lobules affected |
| 1 < 33%; 2 ∼ 33–66%; 3 > 66% |
| Secondary dust foci |
| Number of stellate foci |
| To be recorded for each size as follows |
| a < 0.5 cm; b, 0.5–2 cm; c > 2 cm |
| Number of round foci |
| To be recorded for each size as follows |
| a < 0.5 cm; b, 0.5–2 cm; c > 2 cm |
| Emphysema |
| Type: centrilobular, panacinar, or irregular |
| Severity (grade 0 to 3) |
| 1, 1–3 mm; 2, 4–5 mm; 3 > 5 mm |
| Profusion (grade 0 to 3) |
| Can be graded for upper and lower lobes separately or for the whole lung and is similar to that for the primary dust foci |
| Interstitial fibrosis |
| Severity (grade 0 to 4*) |
| A histological grading system is used |
| Extent (grade 0 to 3) |
| 1, ≤ 10% of the lung affected; 2, 10–25%; 3 > 25% |