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Chronic obstructive airway disease due to occupational exposure.
Blanc-PD; Hnizdo-E; Kreiss-K; Toren-K
Asthma in the workplace, fourth edition. Malo J-L, Chan-Yeun M, Bernstein DI, eds. New York: CRC Press, 2013 Jan; :375-391
Long before personal cigarette smoking was widespread, medical writers recognized that "dusty trades" were associated with various lung diseases. "Miner's phthisis" was prototypical of such diseases. This and related conditions (e.g., "grinder's rot'·) were associated with exposure to inorganic dusts and can best be understood by today's nosology as one or another of the pneumoconioses (with or without superimposed tubercular disease). Clinical syndromes consistent with chronic bronchitis or airway obstruction, in particular among persons experiencing heavy organic dust inhalation, were already well described throughout the 19th century. By the mid-20th century, occupational exposures in the various dusty trades were generally presumed to be contributors to chronic bronchitis specifically and, by extension, to airway disrase more broadly defined. For example, a key 1953 analysis of mortality data from the 1930s found that work in dust)' trades, even within the smne social class, was linked to bronchitis morlality. [n 1958, Fletcher noted that "men who work in dusty trades, especially coal miners, have a higher prevalence of symptons of bronchitis and emphysema .. .. ". In the early 1960s, the '"Dutch hypothesis" was articulated, holding that bronchitis and chronic airflow obstruction fell along a spectrum, with the ultimate pathophysiological manifestations of disease dependent on a combination of host and environmental factors. Fletcher's landmark studies, which came to downplay the role of chronic bronchitis in the progression of airway obstruction, coincided with the ascendancy of cigarette smoking as a major independent risk factor for airflow limitation -defined chronic obstructive pulmonary disease (COPD). This fit in with the "British hypothesis," which viewed COPD and asthma as separate processes with distinct causal pathways. The paramount importance of smoking in COPD tended to eclipse all other potential associations. This was especially true of consideration of posslble links between occupational exposures and COPD, with or without concomitant chronic bronchitis.
Airway-obstruction; Airway-resistance; Diseases; Occupational-exposure; Lung-disease; Occupational-health; Occupational-hazards; Occupational-diseases; Pulmonary-system-disorders; Respiratory-system-disorders; Dusts; Dust-particles; Dust-exposure; Epidemiology; Environmental-factors; Environmental-exposure; Risk-factors
Malo-J-L; Chan-Yeung-M; Bernstein-DI
Asthma in the workplace, fourth edition
Page last reviewed: April 12, 2019
Content source: National Institute for Occupational Safety and Health Education and Information Division