OCCUPATIONALLY INDUCED AIRWAYS OBSTRUCTION
Section snippets
IDENTIFYING OCCUPATIONALLY RELATED AIRWAY DISEASES
An occupational respiratory hazard may be identified as a result of a case report, such as in occupational asthma, or by epidemiologic methods. Epidemiologic studies allow the recognition of patterns of disease attributable to an exposure by comparing the occurrence of disease between exposed and unexposed individuals and by evaluating the importance of potential confounding factors such as cigarette smoking. Cross-sectional or prevalence studies of workers actively employed in an industry are
Coal Mining
Pulmonary function and respiratory symptoms have been extensively studied among coal miners in relation to measurements of dust exposure. Exposure to coal dust may result in chronic bronchitis and chronic airflow obstruction unrelated to simple coal workers' pneumoconiosis or to progressive massive fibrosis.
Grain Dust
Grain dust includes particles of grain as well as various insect and rodent parts and excreta, soil (including quartz), mites, and fungi.Exposure to grain dust may cause acute reversible airflow obstruction (asthma) as well as shift-related and harvest season-related decrements in lung function.74 Broder and coworkers16 described a minimal restrictive defect rather than an obstructive defect in association with an increase in grain elevator work over 2.5 months. Respiratory symptoms such as
EXPOSURE TO GASES AND FUMES
Brooks and others19,119 have described reactive airways dysfunction syndrome (RADS), the asthmalike syndrome that may develop following exposure to high concentrations of an irritant gas, vapor, fume, or dust. Workers exposed to high concentrations of sulfur dioxide may develop this syndrome and exhibit persistent bronchial hyperresponsiveness. Inone study of six men followed after exposure, the greatest decrease in FEV1, FEV1/FVC, and FVC occurred at 1 week postexposure.58 Four weeks
CHRONIC PERSISTENT OCCUPATIONAL ASTHMA
Occupational asthma is discussed elsewhere in this issue. Despite removal of the worker from workplace, persistent asthma has beendescribed in asthma because of toluene diisocyanate, Western red cedar, and colophony as well as in crab processors.26,102 Chan-Yeung and coworkers28 described Western red cedar workers with occupational asthma who remained symptomatic on average 3.5 years after leaving work, suggesting that the early diagnosis of occupational asthma may prevent subsequent airflow
Chronic Bronchitis
Korn and coworkers85 reported on the association between respiratory symptoms and occupational exposures to dust or gases and fumes in a random sample of 8515 adults age 25 to 74 residing in six U.S. cities. Lifetime occupational histories were obtained by interviewer. The prevalence of any occupational dust exposure was 45% among the men and 19% among the women; 14% of the men and 10% of the women reported gas or fume exposure. A history of occupational dust exposure, history of exposure to
SUMMARY
The studies reviewed in this article indicate the association of occupational exposure to a variety of organic and inorganic dusts and various gases and fumes with chronic bronchitis and decrements in FEV1. Usually an obstructive pattern was noted, although in some occupations a similar decrement in FVC was noted. The effect of smoking on chronic bronchitis, respiratory symptoms, and FEV1 was usually additive, although workers exposed to cotton dust in one study55 demonstrated an interaction
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Costs of occupational COPD and asthma
2002, ChestCitation Excerpt :Prior studies11–20 have attempted to determine the percentage of obstructive pulmonary disease deaths attributable to occupational hazards—the population attributable risk (PAR)—by estimating epidemiologic associations based on job exposures or occupations, or by identifying self-reported or physician-diagnosed cases of occupational lung disease. We assume, as prior authors11121314151617181920 have, that the prevalence of obstructive lung disease would drop by the PAR if occupational exposures were removed, recognizing that this assumption may be invalid due to biases, competing hazards, and the difficulty of assigning one cause in a multifactorial disease. There is no consensus in the epidemiologic literature regarding the correct PAR for occupational factors that contribute to asthma and COPD.
Occupation and chronic bronchitis among Chinese women
2008, Journal of Occupational and Environmental MedicineEffects of different occupational exposure factors on the respiratory system of farmers: the case of Central Anatolia
2022, Journal of Public Health (Germany)Lung function impairment in construction workers – Influence of smoking and exposure duration
2021, Open Access Macedonian Journal of Medical SciencesQuantitative CT-based structural alterations of segmental airways in cement dust-exposed subjects
2020, Respiratory ResearchCohort profile: The Saskatchewan Rural Health Study - Adult component
2017, BMC Research Notes
Address reprint requests to Eric Garshick, MD, MOH Pulmonary and Critical Care Section Brockton/West Roxbury Veterans Affairs Medical Center 1400 VFW Parkway West Roxbury, MA 02132