Occupational Airways Disease from Chronic Low Level Exposure to Mineral Dusts, Organic Dusts, and Mixed Exposures: Occupational Chronic Obstructive Pulmonary Disease

Abstract

Respiratory disease associated with occupational dust exposure remains a problem despite advances in exposure control. This paper reviews the evidence that chronic nonspecific airflow obstruction leading to chronic obstructive pulmonary disease (COPD) is linked to workplace exposures, in some cases even when exposures are below current regulated standards. Exposures discussed include mineral and metal dust and fumes, including those from coal, silica, asbestos, welding, and metal smelting, and organic dusts such as wood, grain, and mixed agricultural exposures. Emphasis is placed on the role of these exposures in association with airflow obstruction in nonsmokers and on the interaction between exposure and smoking. Evidence is discussed that suggests excess airflow obstruction in young workers may be linked to a worse ultimate prognosis. We argue that, for prevention of further deterioration, clinicians should routinely discuss occupational exposures with their COPD patients, as they do smoking cessation.

Key Words:

COPD - dust exposure - occupational lung disease