Occupational Lung Disease Research Articles

Updated systematic review of respiratory health surveillance: what is the evidence and what are the knowledge gaps?

Occupational health surveillance of respiratory disease, if done properly, should contribute to reducing the burden of occupational lung diseases. However, this systematic review shows that the quality and extent of evidence on the effectiveness of occupational health surveillance for respiratory disease is very limited. Therefore, it is essential to expand the evidence base in order to make informed decisions on the need for any changes to established guidance on health surveillance.

A-022 A pilot study evaluating NT-proBNP and hs-cTnI levels in pneumoconiosis patients with and without cardiovascular diseases

Abstract Background Pneumoconiosis is a serious occupational lung disease in China that is progressive and irreversible but lacks systematic research. This pilot case-control study was conducted to understand levels of N-terminal-pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin I (hs-cTnI) in pneumoconiosis patients with and without cardiovascular diseases. Methods Pneumoconiosis patients with/without cardiovascular diseases were recruited from the West China Occupational Pneumoconiosis Cohort in West China Fourth Hospital. Healthy controls were adults who underwent health check-ups and matched by age with the pneumoconiosis patients at the same hospital. The serum concentrations of NT-proBNP and hs-cTnI were measured by the automated QuidelOrtho™ Vitros™ 5600 system from July 2023 to January 2024. The levels of NT-proBNP and hs-cTnI between the two groups were compared by the Mann-Whitney U test. Results Among 105 male pneumoconiosis patients in our analysis, 63 reported cardiovascular diseases with a median age of 71(61,75) years and 42 without cardiovascular diseases with a median age of 65.5 (58,76) years, with no statistically significant difference (p=0.386). The median NT-proBNP level was 211(102,432)pg/mL for pneumoconiosis with cardiovascular diseases and 104(39.6,190) pg/mL for pneumoconiosis without cardiovascular diseases, the difference beingstatistically significant (p<0.001). The median hs-cTnI level was 2.14(1.50,4.25)ng/L for pneumoconiosis with cardiovascular diseases and 1.50(1.50, 1.52)ng/L for pneumoconiosis without cardiovascular diseases, the difference being statistically significant (p<0.001). Patients who had pneumoconiosis with pulmonary heart diseases had the highest NT-proBNP and hs-cTnI levels,(summarized in Table 1). There was no significant difference in the levels of NT-proBNP and hs-cTnI between patients who had pneumoconiosis without cardiovascular diseases and 65 healthy control participants. Conclusions The incident rate of cardiovascular diseases among pneumoconiosis patients is significantly higher than in the general population, especially pulmonary heart diseases. Future studies are needed to evaluate the levels of NT-proBNP and hs-cTnI in individuals with pneumoconiosis at diagnosis and over time.

Occupational respiratory disease in Eastern Slovakia between 1990-2021: a shift from agriculture to industrial manufacturing.

Occupational allergic respiratory diseases frequently occur in individuals working in the agricultural and food production sectors, textile manufacturing, and industries involving exposure to isocyanates. The study aimed to describe trends surrounding the prevalence of occupational asthma (OA), occupational rhinitis (OR), and occupational hypersensitivity pneumonitis (OHP) in Eastern Slovakia between 1990-2021. All cases of OA, OR, and OHP registered in a database at the Louis Pasteur University Hospital in Košice, Slovakia, between 1990 and 2021, were divided into categories based on economic sector (agricultural, food production sectors, textile manufacturing, healthcare, industrial manufacturing, and tertiary sector) and causal agent. Changes in disease prevalence, causal agents, and economic sector association over time were analysed. There were 287 occupational respiratory cases (179 OA, 65 OR, and 43 OHP cases). The annual prevalence of OA declined significantly over the study period (p < 0.05). Overall, there was a significant decrease in cases from the agricultural (p < 0.001) and an increase in the industrial manufacturing (p < 0.01). The number of cases due to farming agents fell markedly over the study period, while metalworking fluids (MWFs) were found to be the most common causes of allergic respiratory diseases since 2018. This study found a decrease in the number of OA cases, as well as changes in economic sectors and causal agents associated with OA and OHP, specifically, in the agricultural sector, with MWFs from the industrial manufacturing sector now being the most common aetiological agent.

Trends in occupational respiratory conditions with short latency in the UK.

Occupational short-latency respiratory disease (SLRD; predominantly asthma, rhinitis, hypersensitivity pneumonitis, and occupational infections) prevalence is difficult to determine but certain occupations may be associated with increased susceptibility. This study aimed to examine which occupations and industries are currently at high risk for SLRD and determine their respective suspected causal agents. SLRD cases reported to the SWORD scheme between 1999 and 2019 were analysed to determine directly standardized rate ratios (SRR) by occupation against the average rate for all other occupations combined. 'Bakers and flour confectioners' and 'vehicle spray painters' showed significantly raised SRR for SLRD in general, mostly due to occupational rhinitis (234.4; 95% CI 200.5-274.0) and asthma (63.5; 95% CI 51.5-78.3), respectively. Laboratory technicians also showed significantly raised SRR for occupational rhinitis (18.7; 95% CI 15.1-23.1), primarily caused by laboratory animals and insects. Metal machining setters and setter-operators showed increased SRR for occupational hypersensitivity pneumonitis (42.0; 95% CI 29.3-60.3), largely due to cutting/soluble oils. The occupation mostly affected by infectious disease was welding trades (12.9; 95% CI 5.7-29.3), mainly attributable to microbial pathogenicity. This study identified the occupational groups at increased risk of developing an SLRD based on data recorded over a recent two-decade period in the UK. Occupational asthma and rhinitis were identified as the prevailing conditions and hypersensitivity pneumonitis as a potentially rising respiratory problem in the metalworking industry.

Computed Tomography of Contemporary Occupational Lung Disease: A Pictorial Review.

Occupational lung disease remains one of the most common work-related illnesses and accounts for most deaths from occupational illness. Occupational lung diseases often have delayed manifestation over decades and nonspecific clinical presentations, making it challenging for clinicians to promptly identify the disease and implement preventive measures. Radiologists play a crucial role in identifying and diagnosing occupational lung diseases, allowing for removal of the exposure and early medical intervention. In this review, we share our clinical and radiologic approach to diagnosing occupational lung disease and its subtypes. A collection of sample cases of occupational lung diseases commonly encountered in the modern era at a large Canadian university hospital is included to facilitate understanding. This review will provide radiologists with valuable insights into recognizing and diagnosing occupational lung diseases.

Pattern of occupational lung disease among industrial workers attending a medical college of Eastern India.

Occupational lung diseases (OLDs) contribute a significant proportion to the global burden of pulmonary morbidities but are grossly misdiagnosed due to the relative lack of attribution given to occupational exposures. Obstructive lung diseases are known to be associated with long-lasting disability and loss of earning capacity (LOEC) among workers in industrial setups, thus reducing nationwide productivity. In this context, the study aimed to find out the pattern of OLD and factors associated with the severity of it among patients in a tertiary care hospital. The study was a record-based secondary data analysis conducted in the Medical Records Department of a Medical College in Kolkata. A computerized database of patients attending Special Medical Board (SMB) examinations from the Department of Medical Records was utilized for data collection. A data abstraction format was constructed to collect information on pulmonary morbidity, occupational exposure, and sociodemographic and behavioral variables. Extracted data were analyzed in Microsoft Excel and Statistical Package for Social Sciences (SPSS) software. After a review of records, it was shown that 62.3% (66 out of 106 people) of the study subjects had an obstructive type of OLD, the most common being Jute Byssinosis. A negative correlation (Spearman's ρ = -0.136) was found between pulmonary function (FEV1/FVC) and LOEC (%) in the study subjects. In the multivariable logistic regression, exposure to organic dust was found to be significantly associated with worsened lung function {adjusted-Odd's Ratio (95% Confidence Interval) =3.11 (1.1-8.8), P value = 0.03}. OLD is an understated health issue, especially in an industrial diaspora of developing countries, like India. Healthcare facilities should utilize their resources properly for the advancement of medical surveillance in industries where organic dust is produced. Health education of the stakeholders regarding the consequences of OLDs and the benefits of preventive primary approaches will go a long way in alleviating the burden of disease.

Heart condition in occupational bronchitis and chronic obstructive pulmonary disease

The issue of occupational lung diseases, primarily dust lung diseases caused by exposure to industrial fibrogenic aerosols of varying degrees of fibrogenicity, remains relevant. A comprehensive clinical, functional, and bronchoscopic examination was carried out on 172 patients with various forms of lung pathology: chronic dust bronchitis, chronic bronchitis of toxic chemical etiology, and moderate chronic obstructive pulmonary disease. The results of the clinical examination showed that complaints of productive and non-productive cough, shortness of breath, and chest pain were detected in chronic dust bronchitis, chronic bronchitis of toxic chemical etiology, and moderate chronic obstructive pulmonary disease with varying frequencies. Their occurrence and severity depended on the severit y of the pathological process.

Occupational interstitial lung diseases

Avariety of workplace exposures (organic or inorganic dusts as well as gases, fumes, or vapors) can cause diffuse interstitial lung disease. The latency period until onset of the disease can exceed 30years. The disease course varies greatly and depends on the quantity of the inhaled substance and its fibrogenic effect. Pulmonary high-resolution computed tomography (HRCT) patterns do not differ significantly from those of interstitial lung diseases (ILD) of other etiologies. Therefore, without knowledge of the occupational history, work-related ILDs are often classified as idiopathic. In addition, there is increasing evidence in the recent literature that high exposure to silica dust can trigger autoimmune diseases (also involving the lungs). For this reason, aqualified occupational history is now an indispensable part of the interdisciplinary diagnosis of ILDs.

Electrospun porous polyacrylonitrile/polyvinylpyrrolidone nanofiber membrane with ultra-hydrophilic and high moisture-permeability for dust personal protection

The serious dust pollution in coal mine working environment can cause occupational lung diseases and other diseases, affecting the life and health of miners. Therefore, the prospect of developing an air filtration membrane with high filtration performance is of remarkable significance. This study prepared a porous Polyacrylonitrile (PAN) /Polyvinylpyrrolidone (PVP) nanofiber membrane based on Electrospinning and post-treatment technology used for downhole personal protection. The prepared porous nanofiber membrane increased the specific surface area by 133.63 % and the porosity by 391.02 % (compared with the pure PAN nanofiber membrane), and was able to achieve a high filtration efficiency of 98.76 % and a low pressure drop of 165 Pa at an air flow rate of 85 L/min. Meanwhile, this study conducted contact angle and moisture permeability tests on the prepared composite fiber membrane. After 1 second of water droplets falling on the fiber membrane, it had a 14° contact angle (strong hydrophilicity), and the moisture permeability reached 4256.677 cm3/m2·d·Pa, which could discharge the water vapor generated by respiration in time. In addition, given the complex and irregular pore distribution of electrospun nanofibers, the fractal correlation dimension of nanofiber membrane pores was studied through fractal theory, and the relationship between the fractal dimension of fiber pores and respiratory resistance was discussed. Based on this, the nanofiber membrane prepared in this study can be widely used in individual protection in mines.

‘Evaluation of occupational and nonoccupational interstitial lung disease in railway workers’

Introduction Occupational lung diseases include a wide variety of respiratory diseases with clinical manifestations and diagnostic test results that have features similar to nonoccupational diseases. Aim To determine the prevalence of occupational Interstitial lung diseases (ILD) among confirmed ILD patients admitted to the chest department of Egyptian Railway Medical Centre and the assessment of the outcome. Patients and methods A total of 155 patients with confirmed ILD, were subdivided into two groups: group (A) 79 patients with occupational exposure and group (B) 76 patients with nonoccupational exposure. Both groups were subjected to a detailed history, radiological assessment, arterial blood gases, and Spirometry. Data of days of hospital stay were also recorded. Results The prevalence of confirmed cases of ILD among occupational exposure was 1.49% versus 1.1% in the nonoccupational. Range of age in occupational group was between (31and 68 years). Chest X ray (CXR) findings were positive in 58.2% and 30.2% of occupational and nonoccupational group, respectively. Among group (A), 47.1% of the patients stayed between 11 and 15 days), 15.76% admitted to ICU, and 5.2% were mechanically ventilated. While 48% of hospitalized nonoccupational patients stayed between 6 and 10 days, 8% were admitted to ICU and 4% were mechanically ventilated, Conclusion The prevalence of interstitial lung diseases with occupational exposure was 1.49%, higher than non-occupational interstitial lung diseases. They were younger in age, had history of domiciliary oxygen therapy, frequent exacerbations, and previous hospital admissions. They had prolonged length of hospital stay, particularly those not using protective measures.

Lung decellularized matrix-derived 3D spheroids: Exploring silicosis through the impact of the Nrf2/Bax pathway on myofibroblast dynamics

Silicosis is an occupational respiratory disease caused by long-term inhalation of high concentrations of free silica particles. Studies suggest that oxidative stress is a crucial initiator of silicosis fibrosis, and previous studies have linked the antioxidative stress transcription factor known as Nrf2 to fibrosis antagonism. Myofibroblasts play a pivotal role in tissue damage repair due to oxidative stress. Unlike physiological repair, myofibroblasts in fibrosis exhibit an apoptosis-resistant phenotype, continuously synthesising and secreting significant amounts of collagen and other extracellular matrices, which could be a direct cause of silicosis fibrosis. However, the relationship and mechanism of action between oxidative stress and myofibroblast apoptosis resistance remain unclear. In this study, a new 3D cell culture model using mice lung decellularised matrix particles and fibroblasts was developed, simulating the changes in myofibroblasts during the development of silicotic nodules. Western Blot results indicate that silica stimulation leads to increased collagen deposition and decreased apoptosis-related protein Bax and oxidative stress-related protein Nrf2 in the 3D spheroid model. Immunofluorescence experiments reveal co-localisation in their expression. In Nrf2 overexpressing spheroids, Bax exhibits significant upregulation. In the Nrf2 knockout spheroids, Bax is also significantly downregulated; after intervention with Bax inhibitors, a significant downregulation of Bax-induced apoptosis was also detected in the Nrf2-overexpressed spheroids. In contrast, Bax-induced apoptosis showed a significant upregulation trend in Nrf2-overexpressed spheroids after intervention with Bax agonists. The results demonstrate that the spheroid model can mimic the development process of silicotic nodules, and silica stimulation leads to an apoptosis-resistant phenotype in myofibroblasts in the model, acting through the Nrf2/Bax pathway. This research establishes a new methodology for silicosis study, identifies therapeutic targets for silicosis, and opens new avenues for studying the mechanisms of silicosis fibrosis.

Contemporary Concise Review 2023: Environmental and occupational lung diseases.

Air pollutants have various effects on human health in environmental and occupational settings. Air pollutants can be a risk factor for incidence, exacerbation/aggravation and death due to various lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), hypersensitivity pneumonitis or pneumonia (HP), pulmonary fibrosis such as pneumoconiosis and malignant respiratory diseases such as lung cancer and malignant pleural mesothelioma. Environmental and occupational respiratory diseases are crucial clinical and social issues worldwide, although the burden of respiratory disease due to environmental and occupational causes varies depending on country/region, demographic variables, geographical location, industrial structure and socioeconomic situation. The correct recognition of environmental and occupational lung diseases and taking appropriate measures are essential to their effective prevention.

137b - Breathe freely initiative to prevent occupational lung disease – the Australian experience

137b - Breathe freely initiative to prevent occupational lung disease – the Australian experience

137a - Breathe freely initiative to prevent occupational lung disease – Canadian and US rollout

137a - Breathe freely initiative to prevent occupational lung disease – Canadian and US rollout

Вредные вещества в воздухе рабочей зоны горнодобывающего сектора металлурги-ческой промышленности как факторы риска для здоровья работников (аналитический обзор)

Working conditions at non-ferrous metallurgical enterprises typically involve exposure to a whole set of harmful chemicals present in occupational air. These chemicals contribute to the development of pathologies in workers, respiratory diseases in particular. Research literature was analyzed using bibliographic databases in order to summarize available information on effects produced by harmful chemicals in workplace air on health of workers employed at mining enterprises. Respiratory diseases such as pneumoconiosis, acute and chronic dust bronchitis prevail among occupational pathologies typical for underground miners. Acute and chronic bronchitis prevail among respiratory diseases as health disorders resulting in temporary disability of miners dealing with non-ferrous metal mining. Huge amounts of dust appear in occupational air at mining enterprises due to drilling, blasting and ore crushing. Priority chemicals found in workplace air in mining industry include several carcinogens such as nickel, lead, formaldehyde, cadmium, and benzo(a)pyrene. There is a unidirectional effect produced by sulfur dioxide, nickel, nitrogen oxides, acrolein, formaldehyde, cadmium, and particular matter on the respiratory organs. The nervous system can be affected by manganese, lead, and selenium; the blood, by nickel, lead, and carbon oxide; the cardiovascular system, by carbon oxide and selenium. Working conditions of underground miners in non-ferrous metallurgy involve intensive exposure to chemicals in occupational air, which create health risks of occupational respiratory diseases and malignant tumors. Diseases of the nervous, immune, cardiovascular systems and the blood are also possible. When planning a set of preventive activities, it is advisable to identify groups of work-related diseases caused, among other things, by a specific chemical factor.

Harmful chemicals in occupational air in the ore mining sector of the metal industry as occupational health risk factors (Analytical review)

Working conditions at non-ferrous metallurgical enterprises typically involve exposure to a whole set of harmful chemicals present in occupational air. These chemicals contribute to the development of pathologies in workers, respiratory diseases in particular. Research literature was analyzed using bibliographic databases in order to summarize available information on effects produced by harmful chemicals in workplace air on health of workers employed at mining enterprises. Respiratory diseases such as pneumoconiosis, acute and chronic dust bronchitis prevail among occupational pathologies typical for underground miners. Acute and chronic bronchitis prevail among respiratory diseases as health disorders resulting in temporary disability of miners dealing with non-ferrous metal mining. Huge amounts of dust appear in occupational air at mining enterprises due to drilling, blasting and ore crushing. Priority chemicals found in workplace air in mining industry include several carcinogens such as nickel, lead, formaldehyde, cadmium, and benzo(a)pyrene. There is a unidirectional effect produced by sulfur dioxide, nickel, nitrogen oxides, acrolein, formaldehyde, cadmium, and particular matter on the respiratory organs. The nervous system can be affected by manganese, lead, and selenium; the blood, by nickel, lead, and carbon oxide; the cardiovascular system, by carbon oxide and selenium. Working conditions of underground miners in non-ferrous metallurgy involve intensive exposure to chemicals in occupational air, which create health risks of occupational respiratory diseases and malignant tumors. Diseases of the nervous, immune, cardiovascular systems and the blood are also possible. When planning a set of preventive activities, it is advisable to identify groups of work-related diseases caused, among other things, by a specific chemical factor.

Chest x-ray has low sensitivity to detect silicosis in artificial stone benchtop industry workers.

Chest x-ray (CXR) remains a core component of health monitoring guidelines for workers at risk of exposure to crystalline silica. There has however been a lack of evidence regarding the sensitivity of CXR to detect silicosis in artificial stone benchtop industry workers. Paired CXR and high-resolution computed tomography (HRCT) images were acquired from 110 artificial stone benchtop industry workers. Blinded to the clinical diagnosis, each CXR and HRCT was independently read by two thoracic radiologists from a panel of seven, in accordance with International Labour Office (ILO) methodology for CXR and International Classification of HRCT for Occupational and Environmental Respiratory Diseases. Accuracy of screening positive (ILO major category 1, 2 or 3) and negative (ILO major category 0) CXRs were compared with identification of radiological features of silicosis on HRCT. CXR was positive for silicosis in 27/110 (24.5%) workers and HRCT in 40/110 (36.4%). Of the 83 with a negative CXR (ILO category 0), 15 (18.1%) had silicosis on HRCT. All 11 workers with ILO category 2 or 3 CXRs had silicosis on HRCT. In 99 workers ILO category 0 or 1 CXRs, the sensitivity of screening positive CXR compared to silicosis identified by HRCT was 48% (95%CI 29-68) and specificity 97% (90-100). Compared to HRCT, sensitivity of CXR was low but specificity was high. Reliance on CXR for health monitoring would provide false reassurance for many workers, delay management and underestimate the prevalence of silicosis in the artificial stone benchtop industry.

Incidence, mortality, and disability-adjusted life years due to silicosis worldwide, 1990-2019: evidence from the global burden of disease study 2019.

Silicosis is an occupational lung disease because of exposure to silica dust in the workplace. Evidence on the spatiotemporal change of silicosis burden worldwide remains limited. This study utilized data extracted from the Global Burden of Disease Study 2019 to examine the numbers and age-standardized rates of incidence (ASIR), mortality (ASMR), and disability-adjusted life years (DALYs) caused by silicosis between 1990 and 2019. Average annual percentage changes (AAPCs) were calculated to evaluate the temporal trends of age-standardized indicators by sex, region, and socio-demographic index (SDI) since 1990. Results indicated an increase in new silicosis cases globally, rising by 64.61% from 84,426 in 1990 to 138,971 in 2019, with a sustained high number of DALYs attributed to this disease. Although the global age-standardized rates of incidence, mortality, and DALYs of silicosis have decreased since 1990, the number of new cases has increased in 168 countries and territories, and the ASIR of silicosis has also risen in 118 countries and territories, primarily in developing countries. Since 1990, the burden of silicosis among the elderly has significantly increased. Countries with higher SDI experienced a more rapid decline in the silicosis burden. Silicosis remains a public health problem that requires significant attention. Programs for prevention and elimination of this public health issue need to be established in more countries and territories. Protecting young workers from silica dust exposure is crucial to prevent the onset of silicosis in their later years and to reduce the disease burden among older workers.

Occupational Lung Diseases — The Silent Epidemic of this Era

Occupational Lung Diseases — The Silent Epidemic of this Era

Occupational lung diseases from exposure to industrial fibrogenic aerosols of varying degrees of fibrogenicity: occupational risk assessment, features of immunopathogenesis, prediction

The purpose of the study is to assess occupational risk and study the characteristics of immunopathogenesis in occupational lung diseases from exposure to industrial aerosols. Material and research methods. The study included 304 people with over 10 years of work experience under conditions of exposure to high concentrations of industrial fi brogenic aerosols (above the permissible concentration), who underwent an in-depth periodic medical examination at the regional center of occupational pathology Samara City Hospital No. 5 with an assessment of the relative risk (RR), its etiologic fraction (EF), and odds ratio (OR) of the development of occupational respiratory diseases. The comparison group included 120 people. To assess the cytokine profile indices in occupational lung diseases (various degrees of severity of dust-induced occupational diseases, silicosis, and pneumoconiosis from exposure to highly dispersed welding aerosols), 161 people with occupational lung diseases and 60 people in the control group were examined. Levels of immunoglobulins A, M, and G in blood serum, hemolytic activity of complement, and the level of myeloperoxidase were determined using standard reactions. Determination of the levels of total IgE, fibronectin, cytokines IL-1α, IL-1β, IL-4, IL-8, IFNγ, and TNFα, growth factors FGF-2, VEGF in blood serum was carried out by enzyme -linked immunosorbent assay. Results. The occupational risk of developing dust lung diseases from exposure to various types of fibrogenic industrial aerosols, as well as the features of the course of occupational lung diseases have been determined. The identified features of the immu nological profile allow establishing the features of the occurrence, course, and progres sion of occupational lung diseases and recommending changes to the National List of Occupational Diseases. Conclusions. Determining occupational risk and immunological profile allows not only improving the quality of early diagnosis, but optimizing primary and secondary prevention strategies for this pathology, predicting the course of the disease, and reducing the number of disabling forms.