Occupational lung diseases comprise a broad group of diseases, includingoccupational asthma,industrial bronchitis,chronic obstructive pulmonary disease (COPD),bronchiolitis obliterans, inhalation injury,interstitial lung diseases (such aspneumoconiosis,hypersensitivity pneumonitis,lung fibrosis), infections,lung cancer andmesothelioma.[1][2] These can be caused directly or due toimmunological response to an exposure to a variety of dusts, chemicals, proteins or organisms. Occupational cases ofinterstitial lung disease may be misdiagnosed as COPD, idiopathic pulmonary fibrosis, or a myriad of other diseases; leading to a delay in identification of the causative agent.[3][4]
Asthma is a respiratory disease that can begin or worsen due to exposure at work and is characterized by episodic narrowing of respiratory airways. Occupational asthma has a variety of causes, includingsensitization to a specific substance, causing anallergic response; or a reaction to anirritant that is inhaled in the workplace. Exposure to various substances can also worsen pre-existing asthma. People who work inisocyanate manufacturing, who uselatex gloves, or who work in an indoor office environment are at higher risk for occupational asthma than the average US worker. Approximately 2 million people in the US have occupational asthma.[3]
Bronchiolitis obliterans, also known as constrictive bronchiolitis or obliterative bronchiolitis is a respiratory disease caused by injury to the smallest airways, calledbronchioles. It has been reported to occur from exposure to inhaled toxins and gases including sulfur mustard gas, nitrogen oxides, diacetyl (used in many food and beverage flavorings), 2,3-pentanedione, fly ash and fiberglass.[5]
Chronic obstructive pulmonary disease is a respiratory disease that can encompasschronic bronchitis and/oremphysema. 15% of the cases of COPD in the United States can be attributed to occupational exposure, including exposure tosilica andcoal dust. People who work in mining, construction, manufacturing (specifically textiles, rubber, plastic, and leather), building, and utilities are at higher risk for COPD than the average US worker.[3]
Hypersensitivity pneumonitis (HP; also called allergic alveolitis, bagpipe lung, or extrinsic allergic alveolitis, EAA) is aninflammation of thealveoli within thelung caused byhypersensitivity to inhaled organic dusts.[6]
Numerous categories of ionizing radiation, chemicals and mixtures, occupational exposures, metals, dust and fibers have been linked to occurrence of lung cancer.[7]
Mesothelioma is a cancer of themesothelium, part of which is thepleura, the lining of the lungs. Mesothelioma is caused by exposure to asbestos.[3]
Pneumoconiosis are occupational lung diseases that are caused due to accumulation of dust in the lungs and body's reaction to its presence. Most common pneumoconiosis aresilicosis,coal workers’ pneumoconiosis (CWP), andasbestosis. Other examples include minerals (suchkaolin,talc,mica),beryllium lung disease, hard metal disease and silicon carbide pneumoconiosis.[8]
Arsenic is classified as an IARC Group 1 carcinogen and is a cause of lung cancer. Workers can be exposed to arsenic through work with somepesticides or incopper smelting.[3]
Asbestos is a mineral which was extensively used in the United States to fireproof buildings and textiles, among other items, in the 1950s-1980s. Workers are frequently exposed to asbestos during demolition and renovation work, which can cause asbestosis and/or mesothelioma. Asbestos exposure can also causepleural effusion, diffusepleural fibrosis,pleural plaques, and non-mesotheliomalung cancer. Smoking greatly increases the lung cancer risk of asbestos exposure.[3]
Residents and workers of asbestos mining centers such as the town of Asbest, Russia experience dangerous exposure to asbestos and asbestos dust.[9]
BCME (Bis(chloromethyl) ether) is associated withsmall cell lung cancer in workers who have been exposed.[3][10] Exposure can occur via direct manufacture of BCME or its presence as a byproduct.[3]
Beryllium is classified as an IARC Group 1 carcinogen and can also cause interstitial lung disease. Manufacturing workers, dental technicians, machinists, jewelers, plumbers, electricians, precious metal reclamation workers, and welders are at risk for beryllium exposure.[3]
Cadmium is classified as an IARC Group 1 carcinogen and it is a cause of several cancers, including lung cancer. Workers can be exposed to cadmium throughwelding,zinc smelting,copper smelting,lead smelting,electroplating,battery manufacture,plastics manufacture, and inalloying.[3]
Chromium is classified as an IARC Group 1 carcinogen and is linked to lung cancer. Workers can be exposed to chromium viawelding, steel manufacturing, pigment/dye manufacturing, and electroplating.[3]
Exposure tocoal dust is the cause ofcoalworker's pneumoconiosis, also called "black lung disease", is aninterstitial lung disease caused by long-term exposure (over 10 years) tocoal dust. Symptoms includeshortness of breath and lowered pulmonary function. It can be fatal when advanced. Between 1970 and 1974, prevalence of CWP among US coal miners who had worked over 25 years was 32%; the same group saw a prevalence of 9% in 2005–2006. It can also exacerbate or cause COPD.[3]
Diesel exhaust contains a variety of gaseous and particulate chemicals, includingsoot,polycyclic aromatic hydrocarbons, and other known carcinogens.[3]
Flocking is the technique of adding small pieces of nylon or other material to a backing, usually a textile, to create a contrasting texture. Inhalation of flock can causeflock worker's lung.[3]
Indium lung is an interstitial lung disease caused by occupational exposure toindium tin oxide.[4]
The high surface area to volume ratio ofnanoparticles may make them an inhalation hazard for workers exposed to them. This is a topic of ongoing research as of 2015[3] and 2023.https://www.frontiersin.org/journals/bioengineering-and-biotechnology/articles/10.3389/fbioe.2023.1199230/full
Nickel is classified by the IARC as a Group 1 carcinogen; nickel compound exposure is associated withnasal cancer as well as lung cancer. Workers may be exposed to nickel in machining/grinding industry, nickel extraction/production, welding, and electroplating.[3]
Polycyclic aromatic hydrocarbons (PAHs), fused-ring chemicals formed during the combustion of fossil fuels, are metabolized by thecytochrome P450 complex to highly reactivecarbocations, which can mutate DNA and cause cancer. Workers may be exposed to PAHs while working in afoundry, in theroofing industry, or due toenvironmental tobacco smoke.[3]
Exposure to silica can causeSilicosis, which is a fibrosinginterstitial lung disease caused by inhaling fine particles ofsilica, most commonly in the form ofquartz orcristobalite. Short-term exposures of large amounts of silica or long-term (10 years or more) exposure of lower levels of silica can cause silicosis. In 1968, more than 1060 US workers died of silicosis; this number fell to 170 by 2005.[3]
Besides causingsilicosis, inhalation of silica can cause or exacerbate COPD. It can also impair lung function in general and cause cancer by oxidation damage. It is classified as a "known human carcinogen" (Group 1 carcinogen) by theIARC. Exposure is common for people working in tunneling, quarrying, construction, sandblasting, roadway repair, mining, and foundry work.[3]
Silo-filler's disease (not to be confused withfarmer's lung, associated with inhalation of biologic dusts) results from inhalation ofnitrogen dioxide (NO2) gas from freshsilage. The presentation is variable depending on level of exposure. Often the gas penetrates throughout the lung and if severe can manifest as a form ofacute respiratory distress syndrome, such as significant pulmonary edema, hyalinized alveolar membranes, congestion and other respiratory illnesses.[11][12]
Tobacco smoke is a known carcinogen. Workers in the hospitality industry may be exposed to tobacco smoke in the workplace, especially in environments likecasinos and bars/restaurants.[3]
Health care professionals are at risk of occupational influenza exposure; during apandemic influenza, anyone in a close environment is at risk, including those in an office environment.[3]
Tuberculosis is a lung disease endemic in many parts of the world.Health care professionals andprison guards are at high risk for occupational exposure to tuberculosis, since they work with populations with high rates of the disease.[3]
World Trade Center lung is a cluster of diseases caused by exposure to fallout atGround Zero of theSeptember 11 attacks in 2001. These diseases includeasthma, asthmaticbronchitis, terminal airways disease,sarcoidosis, and acuteeosinophilic pneumonia.[4]
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