Hazards in the Workplace Lead to Serious Lung Diseases in More than 1 in 10 People

According to a new report, more than one in 10 people suffer from non-cancerous serious lung diseases due to hazards in the workplace from inhaling lung irritants like dust, fumes, molds, gas and vapors. The official statement was published by the American Thoracic Society (ATS) and the European Respiratory Society, June 1, 2019 in the American Journal of Respiratory and Critical Care Medicine.

The Occupational Burden of Nonmalignant Respiratory Diseases: An Official American Thoracic Society and European Respiratory Society Statement

Thirteen clinical and research experts from the American Thoracic Society (ATS) and the European Respiratory Society assessed dozens of studies that pointed to hazards in the workplace and the development of lung diseases. They did not include cancers of the lung and the pleura membrane surrounding the lung, asbestosis, silicosis and coal workers’ black lung (pneumoconiosis) because these diseases, that  are also a result of occupational hazards have already been extensively reported.

The Role of Occupational Hazards in the Development of Most Lung Disease is Under-recognized

The role of Occupational Hazards in the development of most lung disease is under-recognized according to Dr. Paul D. Blanc, MD, MSPH, chief of the Division of Occupational and Environmental Medicine at the University of California San Francisco. Dr. Blanc together with Dr. Carrie A. Redlich MD, MPH, director of the Occupational and Environmental Medicine Program at Yale University led the research. They emphasize that failing to recognize the role of work-related hazards in the development of serious lung diseases obstructs diagnosis, treatment and the prevention of further disease.

Percentage of Occupational Hazards in Diseases

The authors rate the percentage occupational hazards have in the following diseases:

Asthma……………………………………………………..……………………..16%

Chronic obstructive pulmonary disease (COPD)………..…………14%

Chronic bronchitis……………………………………………………………..13%

Idiopathic pulmonary fibrosis…………………………….………………26%

Hypersensitivity pneumonitis…………………………………………….19%

Sarcoidosis and other granulomatous disease………….…………..30%

Pulmonary alveolar proteinosis……………………………………..……29%

Community Acquired pneumonia (in adults of working age)….10%

Tuberculosis (in workers exposed to silica dust)…………….……….2%

The Lung Diseases that Develop or Worsen from Occupational Hazards Like Lung Irritants

Asthma

Asthma is a chronic disease that causes swelling and inflammation of the airways of the lungs. Asthma also cause constriction of muscles that lead to narrowing of the airways. Asthma can run in families and allergies may have a big role in triggering attacks of asthma when breathing is almost impossible. Lung irritants like workplace dust and fumes can trigger the onset of asthma or worsen it.

Chronic Obstructive Pulmonary Disease (COPD)

Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term mainly for emphysema and chronic bronchitis. You can read more about COPD in our blog post from March 28, 2019.

Idiopathic Pulmonary Fibrosis

Pulmonary fibrosis (PF) describes a group of lung diseases that causes a thickening of the walls of the air sacs (called alveoli), caused by scarring. PF can result in cough, shortness of breath, fatigue and low blood oxygen levels. In some cases there is a known lung irritant that caused pulmonary fibrosis. Idiopathic pulmonary fibrosis (IPF) is where the cause is unknown, but this study has pinpointed workplace hazards as a likely cause.

Hypersensitivity Pneumonitis

Hypersensitivity pneumonitis is inflammation of the lungs due to inhaling foreign substances in the workplace like certain types of dust, fungus, or molds.

Sarcoidosis

Sarcoidosis is a disease of unknown cause whereby inflammatory cells clump together and form tiny lumps of cells most commonly in the lungs.

Pulmonary Alveolar Proteinosis

Pulmonary alveolar proteinosis is a rare lung disorder characterized by an abnormal buildup of certain kinds of lipoprotein compounds within the air sacks (alveoli) of the lung.

Community Acquired Pneumonia

Community acquired pneumonia) is mainly from viral or bacterial infections that cause inflammation of the air sacs in the lungs. When the airways are also involved, it may be called bronchopneumonia.

Tuberculosis

Tuberculosis is a highly contagious disease that if untreated can lead to scarring of the lungs and may even make a hole in the lungs. Silica dust has been found to increase the risk for tuberculosis.

Summation

While the role of the connection between hazards in the workplace and COPD and asthma reinforces earlier research, the estimates for occupational hazards like lung irritants for developing idiopathic pulmonary fibrosis and community-acquired pneumonia point out a new risk.

Dr. Blanc and the authors hope that this report will encourage physicians to ask patients where and how they work in the hope to prevent further deterioration from the lung disease.

The Need for Long-term Care

Many patients with severe lung diseases end up needing to go to a skilled long-term rehabilitation and nursing facility such as the Van Duyn Center for Rehabilitation and Nursing in Syracuse, New York. Van Duyn has a Respiratory Wellness unit that is staffed by professional respiratory therapists. Van Duyn also has wonderful recreational therapy programs and the air in Syracuse has been rated by the American Lung Association for being among the cleanest cities in America for fine particle air pollution:

• Ranked 122 for high ozone days out of 227 metropolitan areas
• Tied for 1st for cleanest metropolitan areas in the country for 24-hour particle pollution
• Ranked 174 for annual particle pollution out of 187 metropolitan areas

Conclusion

More has to be done in the workplace to protect workers from dangerous occupational lung irritants that can lead to disability and even the loss of life.