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Chapter 40. Occupational and Environmental Lung Diseases

Clayton T Cowl, MD, MS, FCCP
DOI: 10.1378/pulm.26.40
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Sections

Objectives 
  • Recognize differences between impairment and disability.

  • Appreciate general concepts in assessing individuals with suspected occupational or environmental conditions, noting the importance of a detailed occupational and environmental history.

  • Recognize the complexity of assessing occupational lung disease in terms of addressing exposure and handling administrative aspects involved, such as writing work restrictions.

  • Define work-related asthma and understand the conceptual framework for the differences between work-exacerbated asthma and occupational asthma.

  • Know classification of sensitizer-induced asthma, including examples of high-molecular-weight and low-,molecular-weight antigens.

  • Recognize work-related asthma without latency (reactive airways dysfunction syndrome).

  • Understand essential concepts of diagnosing and treating a variety of work-related pulmonary conditions.

  • Review illnesses associated with acute toxic inhalations.

Synopsis 

Occupational and environmental lung diseases encompass respiratory system dysfunction caused by or exacerbated by contact with antigens or irritants that are inhaled, resulting in acute or chronic illness. There is a wide spectrum of conditions included in this category of pulmonary dysfunction, and assessment and management of administrative issues surrounding occupational and environmental lung disease is often one of the more challenging aspects of caring for individuals encountering illnesses or injuries associated with workplace exposures. Although occupational asthma is often the condition most commonly associated with environmental respiratory illness inhalational exposures may involve a variety or mixture of compounds including toxic substances, metal fumes, or organic antigens.

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