Health & Safety: Leading respiratory illness linked to workplace exposures
Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. While cigarette smoking is the ...
Chronic obstructive pulmonary disease (COPD) is a leading cause of death worldwide. While cigarette smoking is the main cause of COPD, studies conducted around the world are showing a link between workplace exposures to harmful dusts, gases, vapours, and fumes and COPD.
COPD is an umbrella term used to describe a group of lung diseases associated with airflow obstruction — insufficient flow of air into or out of the lungs. Emphysema and chronic bronchitis are conditions that are included in COPD, and they may co-exist.
COPD is a chronic, debilitating and sometimes fatal disease. Experts predict that with an aging population and the size of the at-risk population growing steadily, the incidence of COPD will likely increase dramatically.
The disease is typically not diagnosed until the fifth decade of life (in people aged 40-49 years). Common signs and symptoms of COPD include a chronic productive cough that’s worse in the morning, or an acute chest illness, a greater effort to breathe, shortness of breath and wheezing, especially during exertion and when their condition worsens.
As COPD progresses, the person may experience discoloration of the skin, shorter intervals between periods of acute shortness of breath, failure of the right side of the heart, loss of appetite and/or weight loss.
COPD is a progressive and irreversible disease for which there is no cure. The costs associated with COPD affect the family, the healthcare system and the community. The disease places a profound burden on patients that may include medical emergencies and hospitalizations, work absenteeism and limitations on their activities.
The shortness of breath associated with COPD causes significant activity restrictions that interfere with the everyday tasks most people take for granted: dressing, washing, talking and sleeping. Families of the patients are faced with the challenge of providing an increasing level of care, and the difficulty of watching the progression of the disease in their loved ones.
While smoking is the main cause of COPD in Canada — and outdoor air pollution is another — the American Thoracic Society estimated in 2002 that 15% of both asthma and COPD worldwide is likely work-related.
There now appears to be reasonable evidence to support occupational exposures as an independent cause of COPD. This means regulators, employers and occupational health professionals now need to consider what has to be done to reduce relevant exposures.
Researchers have linked COPD to prolonged occupational exposures to airborne contaminants which can cause chronic airflow obstruction, even in non-smokers. However it is difficult to determine the prevalence of COPD because it does not usually appear until mid-life, when the disease is already moderately advanced. This is further compounded by the fact that COPD develops slowly, and current cases of potential work-related COPD likely reflect workplace exposures from the past few decades.
With respect to workplace exposures, people who are exposed to harmful airborne dust, vapours, fumes and gases are most at risk of developing COPD.
Work-related respiratory hazards may come in the form of coal dust, silica, cadmium and asbestos in coal mines; fumes from spray paints and welding applications; dusts from food products and textiles; wood dust at construction sites; and other airborne toxins at industrial sites that manufacture leather, rubber and plastics.
What can be done to prevent occupation-related COPD?
Recent reports on studies on COPD offered a number of suggestions. Regulators should take action to reduce workplace exposures through engineering and other hygiene. Health practitioners, workers, and employers need to be made aware of the hazards posed by airborne exposures to harmful chemicals at work. Medical clinicians must determine potential occupational causes for COPD to support early detection and the best opportunity for preventing disability and mortality, and for epidemiological case reporting. Lastly, efforts to reduce tobacco smoking should be accompanied (where appropriate) by initiatives to reduce or eliminate occupational exposures.
Early diagnosis and treatment of COPD are key to slowing the progression of the disease and helping the patient feel healthier.