Occupational chronic obstructive pulmonary disorder: prevalence and prevention

ABSTRACT

Introduction

Occupational chronic obstructive pulmonary disorder, i.e. work-related asthma (WRA) and occupational chronic obstructive pulmonary disease (COPD), are the most common occupational lung diseases in the last decades worldwide. As in the case of the other occupational disorders, these diseases may be prevented.

Areas covered

WRA is a heterogeneous entity that includes three subtypes, immunologic occupational asthma (OA), irritant-induced asthma (IIA), and work-exacerbated asthma (WEA), depending on the role of occupational exposures as a causing or aggravating factor of the disease. In addition, there is consistent evidence that a substantial proportion of COPD cases can be explained by exposure to noxious particles and gases other than tobacco smoke, such as workplace dusts, gases, fumes, and vapors. The articles cited in this paper were searched by keywords in several databases in the period up to May-July 2021.

Expert opinion

The development of occupational chronic obstructive disorder is a matter of prevention. WRA and occupational COPD contribute significantly to the overall burden of asthma and COPD. Activities and measures targeted to elimination or reduction of harmful workplace exposures, as well as to early detection and early intervention in the course of the lung damage, can significantly reduce the burden caused by these diseases.

KEYWORDS:

• Occupational asthma
• occupational exposures
• occupational COPD
• work-exacerbated asthma
• work-related asthma

Article highlights

• Occupational chronic obstructive pulmonary disorder has a substantial impact on morbidity, disability and mortality of the general population causing serious economic costs.

• Up to 30% of all adult asthma cases are caused or aggravated by workplace agents or conditions (work-related asthma).

• In up to 15% of all adults of working age with asthma the disease has developed after sensitization to certain occupational agent (immunological occupational asthma or sensitizer-induced occupational asthma).

• Non-immunological type of occupational asthma (irritant-induced occupational asthma), i.e. a type of occupational asthma caused by exposure to occupational irritants, affects less than one-fifth of workers with occupational asthma.

• Prevalence of work-exacerbated asthma, i.e. a type of work-related asthma aggravated or reactivated by workplace agents or conditions, is estimated to 15-20% of all adult cases with asthma.

• Up to 20% of all cases with chronic obstructive pulmonary disease are caused or made worse by occupational exposures.

• The highest risk of chronic obstructive pulmonary disease is found in smoking workers from ‘dusty occupations’.

• Occupational chronic obstructive pulmonary disorder is potentially preventable.

• Engineering and administrative control of occupational exposure, personal protective equipment, and education and training of workers and health professionals are the cornerstones of occupational chronic obstructive disorder.

• Periodical medical examinations of the workers are the basis of the secondary prevention of occupational chronic obstructive pulmonary disorder.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.