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Open Access
An Overview of Major Occupational Lung Diseases
Yet new and uncharacterized agents and hazardous materials continue to be intro- duced into industries, supporting the need for more research in the field (Cullinan et al., 2017; De Matteis et al., 2017; Fazen et al., 2020). Therefore, it is essential to con- tinue to research occupational lung diseases, which are one of the most common classes of occupationally induced injuries (Perlman & Maier, 2019; Rushton, 2017; Sirajuddin & Kanne, 2009). Of the 140 million U.S. workers who are at risk for occupational injuries and illness, approximately 1 mil- lion report occupational exposure-related illnesses, including respiratory diseases (Goldyn et al., 2008). Despite workplace improvements—from technological advances to preventive mea- sures and government enforcement of indus- trial standards and regulations—occupational diseases remain a major challenge (Cullinan et al., 2017; Rushton, 2017; Sirajuddin & Kanne, 2009). The cost of healthcare remains high, and occupational lung disease is not an exception. According to the Centers for Dis- ease Control and Prevention (CDC), medical expenses in 2017 for work-related asthma and COPD were $7 billion and $5 billion, respec- tively (Syamlal et al., 2020). Moreover, Goldyn et al. (2008) estimated that $26 billion is spent annually for occupational exposure-related illness, which includes respiratory diseases. Furthermore, data from research focusing on Great Britain, Canada, and France indicate that 2–5% of the cancer burden is associ- ated with occupational exposures (Olsson & Kromhout, 2021). In this article, we base our evaluation on a literature search of major occupational lung diseases. We highlight current information and discuss the rationale and available preven- tive strategies and regulations to prevent occu- pational exposures and protect all workers. Alexander C. Ufelle, MBBS, MPH, PhD Department of Public Health Sciences, Slippery Rock University Angela Mattis Bernardo, PhD Department of Safety Management, Slippery Rock University Adelle Williams, MBA, PhD Department of Public Health Sciences Slippery Rock University
Abstract Occupational lung diseases result from worker exposure in occupational settings to unhealthy environments and agents, such as silica dust, antigens, coal dust, washed coal/mixed dust, asbestos, and beryllium. Most of these conditions have long latency periods, with disease manifesting years after exposure. Approximately 1 million workers in the U.S. report occupational exposure-related illnesses, including respiratory diseases. We evaluated major occupational lung diseases via an extensive literature review and present here advances in diagnosing major occupational lung diseases, preventive strategies, and regulatory considerations for maintaining a healthy workforce. We include the widely studied occupational lung diseases asbestosis, coal workers’ pneumoconiosis and all other pneumoconioses, silicosis, byssinosis, malignant mesothelioma, hypersensitivity pneumonitis, and work-related asthma. The chemistry and physical properties of exposed materials play a role in the severity and pathogenesis of most occupational lung diseases. Knowledge of clinical signs and symptoms of these diseases, exposure history, and consensus diagnostic tools and criteria are crucial for accurate diagnosis, early detection, management, and improved outcomes. Further, regulatory agencies and other interested parties need to develop new and improved surveillance strategies, exposure limits, and technological and industrial safety measures, as well as implement regulations to guide industries and provide recommendations to protect all workers and reduce disease burden. Keywords: diagnosis, disease burden, occupational lung diseases, prevention, regulations, latency period
Introduction Widely studied occupational lung diseases include asbestosis, coal workers’ pneumoco- niosis (CWP) and all pneumoconioses, sili- cosis, byssinosis, malignant mesothelioma, hypersensitivity pneumonitis, asthma, chronic obstructive pulmonary disease (COPD), and lung cancer (Cullinan et al., 2017; Perlman & Maier, 2019; Reid & Reid, 2013; Schwartz & Peterson, 1998; Sirajud- din & Kanne, 2009). Occupational lung diseases result from exposure of workers in
the occupational setting to agents and condi- tions such as silica dust, antigens, coal dust, washed coal/mixed dust, asbestos, beryllium, and metals (Perlman & Maier, 2019; Sira- juddin & Kanne, 2009). Occupational lung diseases are avoidable by preventing worker exposure to workplace hazards (De Matteis et al., 2017), which can be accomplished by eliminating the hazards and using engineer- ing controls, administrative controls, and personal protective equipment (PPE) such as respiratory protective equipment.
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Volume 87 • Number 4
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