Workplace Exposures Contribute to Burden of Respiratory Disease

Workplace exposures contribute to the burden of respiratory conditions, according to a statement issued by the American Thoracic Society and European Respiratory Society and published in the issue of the American Journal of Respiratory and Critical Care Medicine.

Paul D. Blanc, M.D., from the University of California in San Francisco, and colleagues conducted a systematic review to examine the occupational contribution to the burden of major nonmalignant respiratory diseases. The occupational population-attributable fraction (PAF) was estimated for respiratory conditions for which there were sufficient population-based studies to allow pooled estimates, while for other conditions, the occupational burden of disease was estimated based on case series, incidence rate ratios, or attributable fractions.

The researchers found that workplace exposures contribute substantially to the burden of several chronic respiratory diseases, including asthma, chronic obstructive pulmonary disease, chronic bronchitis, idiopathic pulmonary fibrosis, and community-acquired pneumonia in working-age adults (PAFs, 16, 14, 13, 26, and 10 percent, respectively). Workplace exposures also contributed to the burden of hypersensitivity pneumonitis (occupational burden, 19 percent); other granulomatous diseases, including sarcoidosis (occupational burden, 30 percent); pulmonary alveolar proteinosis (occupational burden, 29 percent); and tuberculosis (occupational burden, 2.3 and 1.0 percent in silica-exposed workers and health care workers, respectively).

"The role of occupational factors in most lung disease is underrecognized," Blanc said in a statement. "Failure to appreciate the importance of work-related factors in such conditions impedes diagnosis, treatment and, most importantly of all, prevention of further disease."

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