Occupational and environmental lung disease

What it is

Family physicians should be aware of the environmental exposures associated with pulmonary disease. The line runs from a named exposure to a named disease, so the occupational and environmental exposure history is the part of the history that carries the diagnosis.

Causes and risk

• Stone cutting, sand blasting, mining and quarrying expose patients to silica, an inorganic dust that causes pulmonary fibrosis, that is silicosis. The exposure is inhalation of crystalline silica, most commonly as dust, in sandblasting, hydraulic fracturing, ceramics production, quarrying and glass manufacturing.
• Occupational exposure to beryllium, which is also an inorganic dust, occurs in the high-tech electronics manufacturing industry and results in chronic beryllium lung disease.
• Exposure to organic agricultural dusts (fungal spores, vegetable products, insect fragments, animal dander, animal feces, microorganisms and pollens) can result in farmer's lung, a hypersensitivity pneumonitis.
• Other organic dust exposures, such as exposure to grain dust in bakers, can lead to asthma, chronic bronchitis and COPD.
• Firefighters are at risk of smoke inhalation and are exposed to toxic chemicals that can cause many acute and chronic respiratory symptoms.

The occupational causes of lung fibrosis also hold farmer's lung, coal miner, asbestosis in the lower zone, silicosis in the upper zone, lead, and bird fancier's lung.