Environmental and occupational lung diseases result from inhalation of dusts, chemicals, gases, fumes, and other airborne exposures. The lungs are continually exposed to the external environment and are susceptible to many occupational and environmental challenges. Disease resulting from environmental or occupational exposures can involve any part of the lungs, including the
Airways, which are the organs (such as the throat, trachea, and bronchi) that bring air to the lungs
Alveoli, which are the tiny air sacs of the lungs
Pleura, which are membranes that line the chest cavity and surround the lungs
As examples, the airways are affected in work-related asthma, reactive airways dysfunction syndrome, toxic inhalations, air pollution–related illness, or byssinosis. Alveoli are affected in pneumoconioses (such as coal worker pneumoconiosis), hypersensitivity pneumonitis, or silicosis. The pleura are affected in asbestos-related diseases.
Inhalation exposures have long been known to cause asthma (see work-related asthma). More recently, they have also been recognized as a cause of COPD (chronic obstructive pulmonary disease) both in people who smoke and those who do not. Inhalational environmental exposures can also worsen pre-existing lung disease, such as asthma and COPD.
Doctors who suspect an environmental or occupational lung disease ask specifically about industry and job tasks, past and current exposures, and whether symptoms seem to be related to work, home, or other environments.
Workers at Risk of Environmental or Occupational Lung Disease
Disease | Affected Workers |
|---|---|
Construction workers and home remodelers who install or remove materials (including insulation) that contain asbestos Shipyard workers Workers who mine, mill, or manufacture asbestos | |
Aerospace workers Metallurgical (castings) workers | |
Bronchiolitis obliterans | Flavorings workers (popcorn workers’ lung) Military personnel deployed to Iraq or Afghanistan |
Cotton, hemp, jute, and flax workers | |
Coal workers | |
Office workers when the air-conditioning systems become contaminated by certain fungi and bacteria Swimming pool and spa workers (because of contaminated sprays) Farmers, mushroom workers, milling and construction workers, bird keepers, people exposed to isocyanates (urethanes) | |
People who work with irritants or allergens such as flour, grains, wood dust, isocyanates (urethanes), dyes, antibiotics, epoxy resins, cleaning products, molds, latex, animal hair, shellfish, metals (chromium and nickel), irritating gases, vapors, and mists Military personnel deployed to Iraq or Afghanistan | |
Miners Foundry workers Potters Sandblasters Sandstone or granite cutters Workers who cut, grind, and finish products made from stone or synthetic stone (such as engineered silica countertops) Tunnel workers |
Prevention
Prevention of environmental and occupational lung diseases centers on reducing or eliminating exposure to substances that can cause disease. In the order of most to least effective, exposure can be reduced or eliminated with these measures:
Removing the hazard from the workplace
Substituting with safer, less toxic materials
Implementing engineering controls (that is, controlling the environment, for example, with enclosures, ventilation systems, safe clean-up procedures)
Using administrative controls (for example, limiting the number of people exposed to hazardous conditions)
Using personal protective equipment (for example, a respirator or dust mask)
Although respirators reduce exposure, they are generally the least preferred type of preventive measure. They should be considered when more effective interventions are not feasible or do not sufficiently reduce the hazard. Respiratory protection typically is worn for high-risk specific tasks and not for an entire workday.
When a respirator is required to protect a worker's health, the worker should be enrolled in the employer-mandated written respiratory protection program, which includes medical evaluation and annual respirator fit testing to ensure proper fit. Medical evaluation includes assessment of whether the person is able to wear the type of respirator that will be used in the workplace.
Medical surveillance is another element of prevention. In medical surveillance, scheduled evaluations of a worker, such as with lung function tests or chest imaging, are conducted to identify disorders early when exposure reduction and other interventions might help reduce long-term consequences. The United States Occupational Safety and Health Administration (OSHA) mandates medical surveillance for select exposures, such as asbestos and silica.
More Information
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
United States Department of Labor, Occupational Safety and Health Administration, Standard Number 1910.134 - respiratory protection
European Agency for Safety and Health at Work: Respiratory Protection Equipment — Requirements and Selection. Published 17/06/2013. Updated 07/10/2020.
