OCCUPATIONAL LUNG DISEASE

The lungs are one of the body's organs most in contact with the surrounding environment. Thousands of breaths are taken each day, and if there are hazardous substances in the air many types of disease may develop.

Among the occupational lung problems are asthma and the closely related hypersensitivity pneumonias; irritant and toxic gases, some of which may prove rapidly fatal; cancer-causing agents; inorganic dusts, such as cement, which cause acute bronchitis; organic dusts that produce a variety of problems, such as byssinosis, which is caused by cotton dust; and the pneumoconioses, or chronic dust-caused diseases of the lung.

Most, if not all, of these problems are entirely preventable. For some, such as byssinosis, there is now better recognition and response, leading to the development of fewer new cases. Similarly, stricter regulations over time have reduced the incidence of some of the pneumoconioses, but others continue to be significant health problems, including silicosis in certain groups of silica-exposed workers, such as sandblasters. With lower levels of exposure to asbestos the risk of asbestos has been diminishing, but the cancer-associated risks continue.

A wide variety of substances in many workplace settings can give rise to asthmatic and allergic phenomena. These include such diverse illnesses as baker's asthma from exposure to flour dust; asthmatic responses to animals among those who regularly handle them, such as veterinarians or research scientists; and sensitization to plastics, such as occurs in meat wrapper's asthma or in those who solder wires that are coated with teflon. A wide variety of organic materials can lead to hypersensitivity pneumonias. These include "tea picker's lung" and "coffee grinder's lung."

If any gas replaces enough oxygen at a worksite, a worker may die from simple asphyxiation due to the lack of oxygen. More frequently, however, other effects occur such as the acute and chronic damage to the lung caused by oxides of nitrogen that occur in agricultural silos or damage from acute exposure to chlorine, ammonia, and other chemicals widely used in chemical production facilities. Harmful levels of carbon monoxide can occur from vehicle exhaust in confined spaces or from furnaces or space heaters not working properly. Phosgene can develop from mixing together household-cleaning chemicals.

For the pneumoconioses, first described in the eighteenth century, these scarring diseases of the lung can lead to severe pulmonary distress over time. Among the materials that can cause a pneumoconiosis are asbestos, coal dust, silica, talc, kaolin, mica, flint, and certain metal dusts such as tin, which causes stannosis. Some materials also have carcinogenic potential (such as asbestos and silica). In addition, many of these occupational lung hazards have interactive effects when combined with cigarette smoke.

Arthur L. Frank

(see also: Asbestos; Asthma; Chronic Respiratory Diseases; Lung Cancer; Mining; Occupational Disease; Occupational Safety and Health )

Bibliography

National Institute of Occupational Safety and Health (1986). Occupational Respiratory Disease. Washington, DC: U.S. Department of Health and Human Services.