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Semin Respir Crit Care Med 2023; 44(03): 315-316
DOI: 10.1055/s-0043-1767761
Preface

Updates on the Evaluation, Diagnosis, and New Manifestations of Occupational Lung Disease

Robert A. Cohen
1   Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois
,
Leonard H.T. Go
1   Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois
,
Cecile S. Rose
2   Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, Colorado
3   Division of Pulmonary Science and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Robert A. Cohen, MD
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Leonard H.T. Go, MD
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Cecile S. Rose, MD, MPH

More than 10% of all lung diseases are estimated to result from workplace exposures. This includes diseases caused almost exclusively by work which can be identified with careful medical surveillance, and those that also occur in the general population which are often missed due to the lack of a careful occupational history. Pulmonary specialists must be vigilant in recognizing and managing these preventable diseases. Success in doing so requires familiarity with the latest in surveillance and diagnostic tools and techniques, as well as knowledge of diseases, resulting from newer or previously unrecognized workplace exposures.

Authors from several continents have brought a wealth of evidence and experience to the chapters you'll find in this monograph. Our article offers a review of global trends in occupational lung disease, describing the disturbingly large burden of disease caused by exposures in the workplace.[1] The first and most essential step in the comprehensive evaluation of any patient with respiratory symptoms is the occupational history which is reviewed in detail in by Weissman and Radonovich, with a guide to obtaining an exposure history along with referral to sources which can be of great help.[2] Medical surveillance and diagnostic evaluation of exposed worker populations often involves use and interpretation of physiologic and other biomarkers (described in detail by Dr. Yates)[3] as well as digital chest imaging which can now be evaluated by artificial intelligence applied to computer assisted diagnosis (described by Suganuma and colleagues).[4] It is rare that patients with occupational lung disease require surgical lung biopsy, but Hua and colleagues describe the utility of pathologic and mineralogic analysis of lung tissue and how it can provide substantial information in the evaluation of mineral dust exposed workers.[5]

Often patients present with ‘diseases of ordinary life’ where the contribution of workplace exposure is missed. This is especially true for both occupational COPD and asthma as reviewed by Fishwick and colleagues.[6] It is also true for emerging infectious diseases that place some workers at disproportionate risk. The global pandemic caused by the SARS-CoV-2 virus hit workers in many occupations especially hard. The detailed review offered by Alghader et al sheds light on this underappreciated aspect of the pandemic.[7] Another emerging area in occupational respiratory disease focuses on the inhalational hazards and adverse outcomes in military veterans who deployed to Southwest Asia, reviewed by Krefft and Zell-Baran.[8] New exposures often occur as new industries develop. An example is the cannabis industry in the United States which has exploded over recent years. Workers who labor in this industry face several exposures which, as described by Sack et al, may place them at risk for a variety of lung diseases.[9] Finally, pulmonologists often care for patients suffering from sleep disorders that may have profound effects on work as detailed by Gusman et al.[10]

We hope that pulmonary and occupational medicine practitioners find the chapters in this monograph useful, as they care for patients whose illnesses are caused, contributed to, or exacerbated by exposures at their jobs. Early diagnosis, treatment and mitigation, and/or removal of workers from these exposures can be one of the most important and gratifying interventions a physician can make.



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Artikel online veröffentlicht:
10. Mai 2023

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