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Overview of Environmental Pulmonary Disease

Environmental pulmonary diseases result from inhalation of dusts, allergens, chemicals, gases, and environmental pollutants. The lungs are continually exposed to the external environment and are susceptible to a host of environmental diseases. Pathologic processes can involve any part of the lungs, including the airways (eg, in occupational asthma, reactive airways dysfunction syndrome, or toxic inhalations), interstitium (eg, in pneumoconioses or hypersensitivity pneumonitis), and pleura (eg, in asbestos-related diseases).

Prevention of occupational and environmental pulmonary diseases centers on reducing exposure (primary prevention). Exposure can be limited by the use of

  • Administrative controls (eg, limiting the number of people exposed to hazardous conditions)
  • Engineering controls (eg, enclosures, ventilation systems, safe clean-up procedures)
  • Product substitution (eg, using safer, less toxic materials)
  • Respiratory protection devices (eg, respirator, dust mask, gas mask)

Many clinicians erroneously assume that a patient who has used a respirator or another respiratory protection device has been well protected. Although respirators do afford a degree of protection, especially when fresh air is provided by tank or air hose, the benefit is limited and idiosyncratic. When recommending use of a respirator, clinicians should consider several factors. Workers with cardiovascular disease may be unable to carry out jobs that require strenuous work, especially if they must wear a self-contained breathing apparatus (tank). Respirators that are tight-fitting and that require the wearer to draw air through filter cartridges can increase the work of breathing, which can be especially difficult for patients with asthma, COPD, or interstitial lung diseases.

Medical surveillance is a form of secondary prevention. Workers can be offered medical tests that identify disorders early when treatment might help reduce long-term consequences.

Last full review/revision June 2008 by Lee S. Newman, MD, MA

Content last modified June 2008

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