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NIOSH Respiratory Diseases Research Program

Evidence Package for the National Academies' Review 2006-2007

4. Airways Diseases

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This chapter highlights RDRP research and prevention activities for two major work-related airways conditions: WRA (4.1) and Fixed Obstructive Airways Diseases (4.2) (COPD and bronchiolitis obliterans). While WRA is characterized by reversible airways obstruction, COPD and bronchiolitis obliterans share fixed airways obstruction as a hallmark characteristic. Each disease can be caused by multiple workplace agents and non-workplace agents. Some of the causes for work-related airways diseases are relatively well established at this point, such as natural rubber latex and isocyanates for WRA (4.1a, 4.1b) and coal mine dust for COPD (4.2a). Part of RDRP effort is to identify new causes, and initiate or stimulate preventive actions, as explained for WRA (4.1c), COPD (4.2b), and bronchiolitis obliterans (4.2d). Since asthma and COPD, in particular, can also be caused by non-occupational exposures, it was important to develop valid methods for discerning what is and what is not due to occupational exposures. RDRP efforts to improve detection of the asthma-work relationship are described in 4.1d.  Other activities related to COPD have included estimating the cost and burden of this disease in the U.S. (4.2b) and developing methods for early detection of COPD in order to allow timely interventions (4.2c).