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Semin Respir Crit Care Med 2015; 36(03): 347-357
DOI: 10.1055/s-0035-1549450
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Gene–Environment Interaction from International Cohorts: Impact on Development and Evolution of Occupational and Environmental Lung and Airway Disease

Adam Gaffney
1   Pulmonary and Critical Care Division, Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
2   Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts
,
David C. Christiani
1   Pulmonary and Critical Care Division, Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts
2   Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts
› Author Affiliations
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Publication History

Publication Date:
29 May 2015 (online)

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Abstract

Environmental and occupational pulmonary diseases impose a substantial burden of morbidity and mortality on the global population. However, it has been long observed that only some of those who are exposed to pulmonary toxicants go on to develop disease; increasingly, it is being recognized that genetic differences may underlie some of this person-to-person variability. Studies performed throughout the globe are demonstrating important gene–environment interactions for diseases as diverse as chronic beryllium disease, coal workers' pneumoconiosis, silicosis, asbestosis, byssinosis, occupational asthma, and pollution-associated asthma. These findings have, in many instances, elucidated the pathogenesis of these highly complex diseases. At the same time, however, translation of this research into clinical practice has, for good reasons, proceeded slowly. No genetic test has yet emerged with sufficiently robust operating characteristics to be clearly useful or practicable in an occupational or environmental setting. In addition, occupational genetic testing raises serious ethical and policy concerns. Therefore, the primary objective must remain ensuring that the workplace and the environment are safe for all.

Keywords

genetic susceptibility - occupational disease - environmental disease - lung disease - gene–environment interactions
 

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