Occupational lung diseases in the 21st century: the changing landscape and future challenges

Abstract

Purpose of review Occupational exposures remain an underrecognized and preventable cause of lung disease in high-income countries. The present review highlights the emergence of cleaning-related respiratory disease and the re-emergence of silicosis as examples of trends in occupational lung diseases in the 21st century. Recent findings Employment trends, such as the shift from large-scale manufacturing to a service economy, the growth of the healthcare sector, and changing consumer products have changed the spectrum of work-related lung diseases. Following decades of progress in reducing traditional hazards such as silica in U.S. workplaces, cases of advanced silicosis have recently re-emerged with the production of engineered stone countertops. With growth in the healthcare and service sectors in the United States, cleaning products have become an important cause of work-related asthma and have recently been associated with an increased risk of chronic obstructive pulmonary disease (COPD) in women. However, these occupational lung diseases largely go unrecognized by practicing clinicians. Summary The present article highlights how changes in the economy and work structure can lead to new patterns of inhalational workplace hazards and respiratory disease, including cleaning-related respiratory disease and silicosis. Pulmonary clinicians need to be able to recognize and diagnose these occupational lung diseases, which requires a high index of suspicion and a careful occupational history.

Comparative Transcriptome Analyses Reveal a Transcriptional Landscape of Human Silicosis Lungs and Provide Potential Strategies for Silicosis Treatment

“…Additionally, as a chronic inflammatory lung disease, silicosis shares some common pathogenic mechanisms with chronic obstructive pulmonary diseases (COPD) ( Beamer and Shepherd, 2013 ). Further, epidemiological studies have shown that patients with silicosis are prone to accompany with IPF and COPD ( Fazen et al, 2020 ; Walters, 2020 ). Identifying the shared and specific pathways that are modulated by the three diseases will contribute to a better understanding of the mechanisms underpinning silicosis progression.…”

Dynamic assessing silica particle-induced pulmonary fibrosis and associated regulation of long non-coding RNA expression in Wistar rats

“…During the recent outbreaks of silicosis across Australia since 2015, about 350 silicosis patients have been diagnosed, and many were characterized as accelerated silicosis (AS) which is more rapidly progressive than traditional chronic silicosis [ 2 ]. AS is caused by inhalation of high intensity of RCS from artificial or engineered stones which contain around 90% crystalline silica, much higher than natural stones such as marble and granite [ 3 ]. Compared with traditional silicosis, accelerated silicosis is characterized by severe alveolitis, collagen deposition, and a progressive clinical course that often results in death shortly thereafter [ 4 ].…”

Global incidence, prevalence and disease burden of silicosis: 30 years’ overview and forecasted trends

“…Silicosis is the leading cause of BOD from pneumoconiosis [ 22 , 23 ]. From 1990 to 2019, the incident and prevalent cases of silicosis increased by 64.6% and 91.4% respectively, while DALY numbers only rose by 20.8%.…”