Which Industries Are at Increased Risk?
Mining is just one of the industries whose workers are at an increased risk for developing lung diseases like COPD. Current research supports a strong correlation between loss of lung function and long-term, cumulative exposure to non-organic dust in the workplace.
One study reported that 80 out of 1,000 non-smoking coal miners with cumulative, high levels of dust exposure could be expected to develop a 20% or greater loss of FEV1 attributable to dust. For gold miners, the risk was nearly three times that of coal miners, at less than one-fifth of the cumulative dust exposure.
Other high-risk industries include:
- rubber, plastics and leather manufacturing
- utilities
- building services
- textile manufacturing
- construction
Occupational COPD: Making the Diagnosis
Cigarette smoking is by far the greatest risk factor for COPD. In fact, if you smoke, some doctors won't look beyond that for a diagnosis. But a diagnosis of occupational COPD, independent of cigarette smoking, should be considered in every patient.
During your initial visit, your doctor should ask you about your entire medical history, including information about your current and previous exposure to airway irritants in the workplace. An occupational history should include:
- a list of all your jobs
- your job title(s)
- your job duties
- what, if any, toxins you were exposed to on the job
- the extent and length of time of your exposure
Once your history is known, your doctor will have a better understanding about your potential risk for COPD and will order additional tests to support a diagnosis.
See more about what's involved in a COPD history and physical.
Primary Prevention
The best way to approach occupational COPD is through prevention, both primary and secondary. Not only does prevention help reduce morbidity associated with workplace exposure, but it limits the severe disability that is often associated with the disease.
If you are currently working, the following primary prevention strategies will help you arrest workplace hazards before any damage to your lungs has been done:
- Elimination -- eliminate exposure to airway irritants by completely avoiding them (the best approach) and replace noxious substances with non-toxic agents.
- Engineering controls -- if substitution (as above) is not possible, maintain control by closing off the industrial process and properly ventilating the work area at all times.
- Administrative controls -- transfer to another department or change work duties.
- Protect yourself -- wear personal protective equipment (masks or respirators.)
- Don't smoke -- either inside, or outside the workplace.
Secondary Prevention
Early detection is the key to secondary prevention, a strategy designed to reduce the duration of workplace exposure and limit its severity. The following examples are two important secondary prevention methods:
- Medical surveillance programs that provide health screening questionnaires to employees during the initial hiring process and then repeated on an annual basis.
- Baseline and follow-up spirometry and review of peak expiratory flow rate records for high-risk employees.
Conclusion
Occupational exposure to dusts, chemicals and gases should be considered a well-established risk factor for COPD. Further studies are needed to determine the relationship between the severity of COPD and specific occupations. Until more information can be obtained, prevention remains the primary tool on which to build a strong foundation of understanding about occupational exposure and COPD.
Sources:
Oxman AD, Muir DC, Shannon HS, Stock SR, Hnizdo E, Lange HJ. Occupational dust exposure and chronic obstructive pulmonary disease. A systematic overview of the evidence. Am Rev Respir Dis. 1993 Jul;148(1):38-48.
Piera Boschetto, Sonia Quintavalle, Deborah Miotto, Natalina Lo Cascio, Elena Zeni and Cristina E Mapp. Chronic obstructive pulmonary disease (COPD) and occupational exposures. Journal of Occupational Medicine and Toxicology 2006, 1:11.
