TYPES OF OCCUPATIONAL LUNG DISEASE

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When people breathe in particles from factories, smokestacks, exhaust, fires, mining, construction, and agriculture, on a routine basis, they are at risk of developing occupational lung disease. 

• Asbestosis:  This condition is caused when a person breathes in asbestos fibers.  These tiny fibers are inhaled deep into the lungs where they wedge into the lung tissue.  As a protective mechanism the body coats these fibers with scar tissue as it recognizes them as foreign bodies.  This scarring adds up over time and can make the lungs less elastic and less efficient at gas exchange.

• Coal worker's pneumoconiosis or black lung disease: This disease is caused by inhaling coal dust.  This leads to a chronic inflammatory process that is similar to Asbestosis.  The lungs will have a decreased elasticity and less efficient gas exchange.

• Silicosis: This condition is caused by breathing in airborne crystalline silica.  Silica can also be thought of as dirt or dust particles.  These particles are often found in the air in foundries, construction sites, and mines.  This also causes a scarring of the lungs that makes them less elastic and efficient at gas exchange.

• Hypersensitivity pneumonitis: This is an allergic lung disease caused by breathing in organic materials like spores, fungi, bacteria, bird droppings, etc.  This is often found in people that work on farms.  These allergens cause a chronic inflammatory process that leads to scarring that can make the lungs less elastic and efficient at gas exchange.

• Occupational asthma: Occupational asthma is caused by breathing in any number of irritants.  These people have symptoms in line with asthma.  It is common for people suffering from occupational asthma to have increasingly worse symptoms throughout the work week but for symptoms to dissipate on weekends and vacations.

 

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CAUSES

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Any work site that has irritants in the air could contribute to developing occupational lung disease.  Common problematic work sites include garages, construction sites, shipping yards, farms, foundries, factories, and mines.  Although most problems develop over time, it is important to remember that a single significant exposure can cause damage as well.

 

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SYMPTOMS

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Symptoms may include:

• Coughing

• Shortness of breath

• Shortness of breath with exertion

• Chest pain

• Chest tightness

• Blue nailbeds and/or lips

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DIAGNOSIS

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• Pulmonary function tests (PFTs):  This test can be performed in the office.  Patients with occupational lung disease will often have below normal lung volumes in addition to an impairment in gas exchange.

• Chest X-ray:  This test that takes pictures of the lungs.  Findings may be able to alert your physician to investigate further if showing signs of occupational lung disease.

• Bronchoscopy:  This test uses a flexible tube called a bronchoscope to directly view the lungs.  The physician can take sputum and/or tissue samples directly from areas of concern.

• Lung biopsy:  Tissue sample taken from an area of concern.  The sample is then analyzed by pathology.

• Bronchoalveolar lavage:  This is done during a bronchoscopy and consists of the physician cleansing the area with sterile saline and removing any debris or sputum.  This can then be sent for testing.

• Arterial blood gas:  This test will quantify how well the lungs are getting oxygen into the body and carbon dioxide out of the body.

• Computed tomography scan (CT or CAT scan):  This imaging test shows more detail than an x-ray.  This may be ordered by the physician to get a more detailed view of the disease process.

 

 

TREATMENT

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While there is not a cure for occupational lung disease, treatment is geared toward minimizing symptoms and slowing the progression of the disease process:

• Prevent further exposure

• Medications if needed

• Stay active

• Supplemental oxygen if needed

• Pulmonary rehab if needed

• Ventilatory support in severe or end stage disease

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PREVENTION

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Prevention revolves around not putting yourself to be in a position to be breathing in irritants that can cause occupational lung disease:

• Do not smoke or quit if you already are a smoker.

• If you do work in an environment that could cause occupational lung disease, wear proper protective equipment.

• If you do work in an environment that could cause occupational lung disease, ask if they will offer routine pulmonary testing to evaluate for any signs of damage.  If they do not offer this, establish with a pulmonologist and have this evaluated yearly on your own.

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