Who Is at Risk for Occupational Lung Diseases?

Silicosis	Lead, copper, silver, and gold miners
Certain coal miners (for example, roof bolters)
Foundry workers Potters
Sandstone or granite cutters
Tunnel workers
Workers who make abrasive soaps
Sandblasters
Black lung	Coal workers
Asbestosis	Workers who mine, mill, or manufacture asbestos
Construction workers who install or remove materials that contain asbestos
Berylliosis	Aerospace workers
Benign pneumoconiosis	Welders
Iron miners
Barium workers
Tin workers
Occupational asthma	People who work with grains, western red cedar wood, castor beans, dyes, antibiotics, epoxy resins, tea, and enzymes used in manufacturing detergent, malt, and leather goods
Byssinosis	Cotton, hemp, jute, and flax workers
Silo filler's disease	Farmers

 

Text D. Occupational Asthma.

Occupational asthma is a reversible spasm of the airways caused by inhaling work-related particles or vapors that act as irritants or cause an allergic reaction.

Many substances in the workplace can cause spasms of the airways, which make breathing dif­ficult. Some people are particularly sensitive to airborne irritants.

Symptoms

Occupational asthma may cause shortness of breath, a tightness in the chest, wheezing, cough­ing, sneezing, runny nose, and watery eyes. For some people, wheezing at night is the only symp­tom.

Symptoms may develop during work hours but often don't start until a few hours after work. In some people, symptoms begin as much as 24 hours after exposure. Also, symptoms may come and go for a week or more after exposure. Thus, the link between the workplace and the symp­toms is often obscured. Symptoms often become milder or disappear on weekends or over holi­days. They worsen with repeated exposure.

Diagnosis

To make a diagnosis, a doctor asks the person about the symptoms and exposure to a substance known to cause asthma. Occasionally, the allergic reaction can be detected with a skin test (patch test), in which a small amount of a suspected sub­stance is placed on the skin. When making a di­agnosis is more difficult, a doctor uses an inhala­tion challenge test, in which the person inhales small amounts of a suspected substance and is observed for wheezing and shortness of breath and tested for decreasing lung function.

Because the airways may begin to narrow be­fore symptoms appear, a person with delayed symptoms may use a device to monitor the air­ways while at work. This device, a portable peak flow meter, measures the speed at which a person can blow air out of the lungs. When the airways narrow, the rate slows markedly, suggesting oc­cupational asthma.

Prevention and Treatment

Industries using substances that can cause asthma follow dust and vapor control measures, but eliminating the dusts and vapors may be im­possible. Workers with severe asthma should change jobs, if possible. Continued exposure of­ten leads to more severe and persistent asthma.

Treatments are the same as for other types of asthma. Drugs that open the airways (bronchodilators) may be given in an inhaler (for ex­ample, albuterol) or as a tablet (for example, theophylline). For severe attacks, corticosteroids (such as prednisone) may be taken by mouth for a short time. For long-term management, inhaled corticosteroids are preferred.

Notes:

reversible обратимый

tightness напряжение, стеснение, скованность

management лечение

 

Text E. Byssinosis.

Byssinosis is a narrowing of the airways caused by inhaling cotton, flax, or hemp particles.

Byssinosis occurs almost exclusively in people who work with unprocessed cotton. Those who work with flax and hemp may also develop the condi­tion. People who open bales of raw cotton or who work in the first stages of cotton processing seem to be most affected. Apparently, something in the raw cotton causes the airways of susceptible peo­ple to narrow.

Symptoms and Diagnosis

Byssinosis may cause wheezing and tightness in the chest, usually on the first day of work after a break. Unlike with asthma, the symptoms tend to diminish after repeated exposure, and the chest tightness may disappear by the end of the workweek. However, after a person has worked with cotton for many years, the chest tightness may last for 2 or 3 workdays or even the whole week. Prolonged exposure to cotton dust in­creases the frequency of wheezing but doesn't lead to permanent disabling lung disease.

The diagnosis is made by using a test that shows decreasing lung capacity over the course of a workday; usually, this decrease is greatest on the first day of the workweek.

Prevention and Treatment

Controlling dust is the best way to prevent byssinosis. Wheezing and chest tightness can be treated with the drugs used for asthma. Drugs that open the airways (bronchodilators) may be given in an inhaler (for example, albuterol) or as a tablet (for example, theophylline).

Notes:

apparently несомненно, вероятно, очевидно

disabling инвалидизирующий