Respiratory

Occupational Lung Disease

Occupational lung disease is respiratory disease caused or worsened by workplace exposure, spanning occupational asthma, hypersensitivity pneumonitis, pneumoconioses and asbestos-related pleural or malignant disease; the diagnosis changes care because exposure control, specialist referral, workplace protection and compensation pathways become part of treatment.

Definition

Occupational lung disease is respiratory disease caused or materially worsened by inhaled dusts, fumes, vapours, gases, bioaerosols or sensitising agents in the workplace. It includes occupational asthma, hypersensitivity pneumonitis, pneumoconioses, asbestos-related pleural disease, and occupationally related lung or pleural cancer.

First principles

The agent and host response determine the phenotype

Respirable mineral dusts such as silica and asbestos can cause macrophage-driven inflammation and fibrosis. Organic antigens can cause hypersensitivity pneumonitis in a sensitised person, while proteins and reactive chemicals can cause occupational asthma. The same workplace may expose a worker to several agents, so name the task, substance, route and control measures rather than recording only the job title.

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