Occupational Lung Disorders (Asbcstosis; berylliosis, pncumonoconiosis; silicosis)
Numerous occupations expose workers to chemicals, gases, dust, and toxins that can damage the lungs. Asbestos is one of the most familiar of occupational lung hazards, but there are others that are even more lethal. Types of occupational lung disorders include: Pneumoconiosis, caused by industrial dusts or fibers. Asbestosis, a result of inhaling asbestos particles, falls into this category.
Other examples are silicosis, a deadly disease in which nodules of scar tissue containing silica, or quartz dust, form in the lungs; berylliosis, in which the lungs become filled with masses of inflamed tissue called granulomas after exposure to beryllium dust; and black lung disease, which afflicts coal miners.
Workers in many fields are vulnerable to these dust diseases. Construction workers can be exposed to asbestos, but it is also a risk for automobile mechanics who repair old brake linings that were made with asbestos. Silicosis is a hazard faced by miners of gold, lead, copper, and zinc ores embedded in rock that contains quartz. Other jobs that can lead to silicosis include pottery and china making, sandblasting, stone cutting, and working in foundries. Berylliosis is caused by exposure to the dust or fumes of beryllium or its alloys, which are toxic metals used in the electronics, aerospace, and nuclear industries. Because beryllium is present in fumes released into the atmosphere during the manufacturing process, persons living near refineries and plants are also at risk.
About 30 percent of coal miners eventually develop black lung disease. The risk is greater among those who work with anthracite, or hard coal, than miners of bituminous, or soft coal. Organic dust pneumoconiosis, or farmer's lung, an allergic disorder triggered by inhaling mold or dusts from hay and straw or, less commonly, bark, coffee beans, tobacco, and cork. Textile workers exposed to cotton fibers and dust are also vulnerable to this disease. Although organic dusts are not as deadly as those of metals and inorganic compounds, they still can lead to lung scarring and a loss of elasticity similar to the conditions of emphysema. Toxic gases and fumes, which can cause serious lung damage when inhaled. People who work in chemical plants, oil refineries, and dry cleaning plants are vulnerable, as are farmers and others who use pesticides and herbicides.
Symptoms of occupational lung diseases vary, depending upon the cause, and may take years to appear. Breathlessness, frequent coughing that usually produces phlegm, loss of appetite and weight, chronic bronchitis, emphysema, fatigue, chills and fever, and sometimes chest pain are common to all of these diseases.
Diagnostic Studies and Procedures
The patient's symptoms and job background provide important clues in diagnosing an occupational lung disease. The doctor will want detailed descriptions of the workplace, the types of substances used, and safety precautions followed. Because occupational lung diseases often take 10 or more years to develop, it is necessary to find out about jobs even in the distant past.
Nonoccupational pursuits such as hobbies that involve exposure to toxic substances should also be investigated. Family members may also have been exposed to toxic materials brought home on work clothes, skin, and hair. Chest X-rays, lung function tests, and biopsies are the mainstays of diagnosis. The X-ray will reveal characteristic opaque areas in the lungs. A biopsy often confirms the type of disease and may also detect the presence, of cancer, a common complication of many occupational lung disorders. Phlegm and sputum samples might be studied for the presence of infection.
If berylliosis is suspected, broncho0alveolar exam will be performed. In this procedure, a bronchoscope, a viewing tube with magnifying devices is inserted through the mouth and into the lungs. A fluid is then injected through the tube to wash up cells from the bronchial lining. Berylliosis is diagnosed if the cells are found to contain elevated levels of beryllium.
Medical Treatments
For the most part, these diseases are incurable and treatment usually is directed to alleviating symptoms. As lung failure advances, supplementary oxygen may be needed. Preventive antibiotics may be prescribed at the first sign of a cold or flu to head off a secondary lung infection.
Berylliosis is sometimes treated with steroid drugs. Hospitalization may be necessary during an acute episode in which the lungs are inflamed. Patients with severely swollen or bleeding lungs may need assistance with a ventilator.
To treat black lung, bronchodilators may be prescribed. These drugs open the airways, making it easier to breathe. Steroids may also be used to prevent bronchospasm, in which the muscles that line the bronchial tubes contract and tighten. Diuretic drugs help control the buildup of fluid in the lungs.
Silicosis is difficult to treat, and there is no cure. Medications for shortness of breath and coughing are prescribed, as are bronchodilators and antibiotics.
Farmer's lung is usually treated with steroids to reduce inflammation, hospitalization may be necessary in severe cases, but the outlook is more optimistic than that of other occupational lung disorders. In fact, the symptoms often disappear if contact with the offending molds or dust can be avoided.
Alternative Therapies
No alternative therapy can cure serious lung diseases, but some alleviate symptoms and make breathing easier.
Aromatherapy. Inhaling steam to which eucalyptus oil has been added helps to loosen lung secretions and improve breathing.
Herbal Medicine. Drinking a hot tea made from elecampane root thins phlegm and mucus.
Horehound, taken as a decoction, syrup, or a tincture, may also help to clear sputum.
Hydrotherapy. A hot, steamy bath or shower helps to open up the airways. Conversely, a cold pack placed on the chest sometimes relieves lung congestion and makes breathing easier.
Physical Therapy. A respiratory therapist teaches special breathing methods and exercises, as well as a postural drainage technique to help clear secretions from the lungs.
An occupational therapist may be consulted for ways to conserve energy when performing tasks.
Self-Treatment
Prevention is the best approach to occupational lung disorders. Make sure that your workplace meets mandated safety standards, with adequate ventilation and protective gear. Employers should be providing laundered work clothes plus washing facilities and showers so that workers can change into their street clothes at the end of their shift. Also, vacuuming, wash down procedures, and wet sweeping can help reduce the dust.
Do not eat or drink while working. When you take a break, wash your hands thoroughly before touching any food or beverage. Store your belongings away from work areas, in a closed space where they are not exposed to dust and other toxic substances. Follow similar safety precautions at home or in your workshop if you are a do-it-yourselfer or hobbyist who regularly works with chemicals and other hazardous substances.
Smoking greatly compounds the risk of occupational lung disorders; if you are a smoker, the single most important thing you can do is to stop. Even a person who has smoked for years can decrease the risk by stopping.
If you should develop an occupational lung disorder, make every effort to avoid any further contact with the offending substance. This is especially important if berylliosis is diagnosed. If possible, change jobs or determine whether you are eligible for disability benefits. Also minimize contact with other substances harmful to the lungs; for example, stay indoors during periods of high air pollution and avoid secondhand tobacco smoke.
Other Causes of Lung Symptoms
Diseases that cause progressive loss of pulmonary function and produce symptoms similar to those of occupational lung disorders include bronchiectasis, sarcoidosis, emphysema, lung cancer, and tuberculosis.