Overview of occupational immunologic lung disease

Abstract

Occupational factors are important in an ever-increasing number of respiratory diseases.’ These include obstructive airways diseases such as asthma, a wide array of interstitial fibrotic and granulomatous diseases, and certain malignant diseases of the lung. It is becoming increasingly apparent that immunologic mechanisms are involved in the pathogenesis of many of these diseases.’ For example, IgE-mediated reactions are often prominently involved in the pathogenisis of many forms of occupational asthma and both immune complex-mediated and delayed cellmediated reactions have been shown to be important in the production of hypersensitivity pneumonitis. Considerably less is known about involvement of such mechanisms in chronic bronchitis or pulmonary fibrosis induced by various inorganic occupational agents. In addition to occupational exposure to gases, vapors, and organic and inorganic dusts, environmental factors such as atmospheric pollution with cigarette smoke and other organic or inorganic particles also often contribute to the development of pulmonary disease in the workplace environment. The enormous increase in the use of simple chemicals and organic compounds since World War II continues to foster