Occupational Lung Disease

WHAT YOU SHOULD KNOW

Technically speaking, any lung problem contracted at work can be considered an occupational lung disease. However, the term is usually reserved for certain specific disorders, including asbestosis, berylliosis, black lung, byssinosis, occupational asthma, occupational lung cancer, and silicosis.

Causes

All of these diseases are due to harmful particles, vapors, gases, or mists that cause damage to the lungs when inhaled during working hours for a long period of time. The American Lung Association divides occupational lung diseases into two major groups: pneumoconioses, caused by dust that gets into the lungs, and hypersensitivity diseases, such as asthma, that are caused by the lungs' overreaction to airborne pollutants. Additionally, some cases of lung cancer and bronchitis are classified as occupational lung diseases, as is the malady called byssinosis. The specific cause varies according to the disease:

• Asbestosis: This disorder is caused by breathing dust from asbestos, the fireproofing and insulating product often used in the past to wrap water pipes and line furnaces and air conditioning ducts. During its heyday, asbestos was also compressed into floor tiles and was even woven into movie theater curtains, hot pads, and ironing board covers. Asbestos dust can cause inflammation and widespread scarring in the lungs.
• Berylliosis: This is a lung inflammation caused by inhaling dust or fumes that contain beryllium, a substance widely used in the aerospace industry and employed in the manufacture of fluorescent bulbs.
• Black Lung: Also known as coal workers' pneumoconiosis (CWP) , this disease is found exclusively in coal miners. Caused by inhaling coal dust, it is marked by scarring in the lungs.
• Byssinosis: The hallmark of this condition is a temporary narrowing of the airways after inhaling particles of cotton, flax, or hemp. The disorder is found almost exclusively in those who work with unprocessed cotton.
• Occupational asthma: The intermittent breathing problems that mark this disorder can be brought on by a wide variety of substances, including paint, hair bleach and dye, foam and packaging materials that emit chemical dusts or vapors, animal hair and dander, organic dust from milled or ground food (such as flour and coffee), dust from textiles, and metals such as chromium and nickel. Western red cedar is also known to cause occupational asthma.
• Occupational lung cancer: Although cigarette smoking is the primary cause of lung cancer, some cases can be attributed to various workplace air pollutants, including arsenic, coal tar, petroleum, and radium.
• Silicosis: This oldest of occupational lung disorders is brought on by inhaling grains of silica (quartz) in mines, foundries, and factories. The particles cause gradual scarring in the lungs that, after many years, may end in emphysema.
• Industrial bronchitis: Bronchitis (inflammation of the passages in the lungs) has a host of causes, including respiratory infections and persistent exposure to irritants such as dusts, gases, vapors, cigarette smoke, and even general air pollution. Because there can be many causes of bronchitis, both inside and outside the workplace, it is often difficult to say whether the problem has its origin in the workplace.

Signs/Symptoms

Depending upon the type and stage of the disease you have, symptoms range from undetectable to severe. Coughing, wheezing, and a tightening in the chest are the most common symptoms. Some people cough up green or yellow sputum. In cases where lung cancer may be suspected, the sputum may be streaked with blood. People with advanced disease may have difficulty breathing or develop abnormal heart rhythms.

Care

No matter which occupational lung disorder you have, it can usually be relieved with drug therapy to reduce inflammation and open the airways, along with oxygen therapy if the symptoms are severe. There are no treatments that offer a complete cure, but once removed from the environment causing the lung disorder, most people learn to successfully manage the disease and go on to lead normal lives.

Prevention is better than any remedy, and in recent years many companies have taken steps to make their facilities safer for their workers, reducing many once-common occupational health hazards. For example, most mining companies now wet down the mines and use state-of-the-art ventilation systems to significantly reduce the dust levels faced by their workers.

Risks

Damaged lungs leave you more vulnerable to potentially life-threatening illnesses such as respiratory failure, tuberculosis, and pneumonia. In severe cases of silicosis and asbestosis, permanent scarring of the lungs can make breathing increasingly difficult.

WHAT YOU SHOULD DO

• Consider changing jobs or occupations to completely eliminate any further exposure to the irritant that brought on the disorder. If the irritant is eliminated early enough, the disease probably won't get any worse
• Take any medications the doctor prescribes exactly as directed. Don't take more than prescribed, and don't discontinue a drug on your own.
• Try to avoid other potential irritants. Place air filters in heating and cooling systems in your home.
• Try to stay away from people who have a cold or the flu. Get shots to prevent flu and pneumonia.
• Use a humidifier to keep the air moist and any sputum thin and easier to cough up.
• Drink 8 to 10 large glasses of water each day. This helps thin the sputum so that it can be coughed up more easily.
• Avoid diary products; they tend to make the sputum thicker and more difficult to cough up.
• Consistently remove dust from your residence and place of work as much as possible. Always wear a face mask covering your nose and mouth while doing so, to filter out the damaging particles.
• If you smoke, give it up. Smoking can severely aggravate the effects of occupational lung diseases such as asbestosis.
• Stay inside during very cold or hot weather and when air pollution is high.

Call Your Doctor If...

• Your sputum gets thicker even though you're taking your medicine and drinking water as directed.
• You cough up sputum that is bloody, yellow, or green.
• Your nail beds stay gray or blue even when breathing is easier.
• You develop a fever.

Seek Care Immediately If...

• You begin coughing up blood.
• You have chest pain or trouble breathing even while resting.
• You feel confused, dizzy, or very drowsy, have swollen hands and feet, and notice that your lips and nail beds have lost color or have turned blue.

If you develop these symptoms, call 911 or 0 (operator) to get to the nearest hospital or clinic. Do not drive yourself.

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

If you suffer severe breathing problems, you may need hospitalization. You're likely to encounter the following procedures and equipment during your stay:

• Oxygen: You may be given extra oxygen through a mask or nasal prongs.
• Taking Vital Signs: These include your temperature, pulse, blood pressure and respiration. A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm. These tests may be performed hourly.
• Pulse Oximeter: This is a clip placed on your ear, finger, or toe and connected to a machine that measures the oxygen in your blood.
• IV: A tube placed in your vein for giving medications or liquids. It will either be capped or have tubing connected to it.
• Medicines: The following drugs will help you breath easier. They may be administered by mouth or given in your IV.
• • Antibiotics: If you have an infection in your lungs, the antibiotics will help to clear it up.
  • Bronchodilators: These are medicines that help to open up your airways. They are typically either inhaled or given in tablet form. For long-term management of the disorder, you may continue to take this medicine after you are discharged.
  • Steroids: These drugs are sometimes prescribed to combat swelling and inflammation of the tissue in your lungs.
• Breathing Treatments: Inhaled medicines are sometimes administered with a special machine. A therapist will help you with these treatments. At first, you may need them frequently. As you improve, you will need them less often.
• Chest X-ray: This picture of your heart and lungs is used to monitor your condition.
• Blood Tests: Samples are taken for testing from a vein in your hand or the bend in your elbow. To measure the level of oxygen and other gases in the blood, additional samples may be drawn from the wrist, elbow, or groin.
• ECG: Also known as a heart monitor, an electrocardiograph or an EKG. Patches placed on your chest are hooked up to a TV-type screen which shows a trace of each heartbeat. Doctors use this tool to watch for signs of heart trouble that could be related to your breathing problems.
• 12 Lead ECG: This test makes tracings from different parts of your heart.