Review Question - QID 213793

A 42-year-old African-American man presents to the physician with cough, shortness of breath, and fatigue for the past year, though he says that his symptoms have worsened in the past few months. He has smoked a half-pack of cigarettes a day since he was a teenager. His family history is significant for coronary artery disease in his father and hypertension in his mother. He has worked for the past 10 years in a stone countertop fabrication factory. Pulmonary function testing reveals decreased residual volume and a normal FEV1/FVC ratio. A chest radiograph is obtained and is shown in Figure A. Which of the following is the most likely cause of this patient’s pulmonary disease?