Prevention Control of Occupational Lung Diseases

Prevention Control of occupational Lung DiseasesPrevention Control of Occupational Lung DiseasesWhat is Occupational Lung Disease?Lung disorder related to matter inhaled from the occupational environment.Occupational lung illnesss ar a broad group of diag beaks caused by the ambition of disperses, chemicals, or proteins.Even persons who do not exploit in the industry fag develop occupational disease with indirect photograph.The effects of an inhaled yearsnt depend on many factors (1)Such as,Physical properties( particle , mist or gas solvability , shape , density , penetrability , concentration , radioactivity , size )Chemical properties(Acidity, alkalinity, fibrogenicity, antigenicity)Susceptibility of the overt person(Integrity of bodys defences, immunologic status)DoseWhat substances in the workstation faecal matter reason for lung disease? (1)Dustfrom such things as wood, cotton, coal, asbestos, silica and talc. Dust from cereal grains, coffee, insecticides, drug o r enzyme dusts, metals and fiberglass be capable to also ache your lungs.Fumesfrom metals that argon heated and cooled rapidly. This procedure results in fine, solid particles being carried in the air. Examples of occupations that involve exposure to fumes from metals and other substances that are heated and cooled quickly accommodate welding, melting, furnace work, ceramic making, plastics manufacture and rubber processes.Smokefrom fiery organic materials. Smoke can contain a variety of particles, gases and vapours, liable on what substance is being burned. Fire-fighters are at an increase riskiness.Gasessuch as formaldehyde, ammonia, chlorine, sulphur dioxide, ozone and nitrogen oxides. These are linked with jobs where chemical reactions occur and in jobs with gamy heat actions, such as welding, brazing, smelting, oven drying and furnace work.Vapours, which are a form of gas given off by all liquids. Vapours, such as those given off by solvents, usually annoy the nose and thro at first, before they affect the lungs.Mistsor sprays from paints, lacquers (such as varnish), hair spray, pesticides, cleaning goods, acids, oils and thinners (such as turpentine).Common Occupational Lung DiseasesObstructive Occupational airwayDiseases.Occupational asthmaOccupational asthma is the most common form occupational lung disease. Occupational asthma (also known as work-related asthma) is asthma that is caused or made worse by exposures in the workplace. Estimates suggest that 15 to 23 percent of new asthma cases in adults are work related (2).Occupational asthma refers to the development of asthma sideline exposure to a known occupational sensitizer (often with evidence of an elevated specific immunoglobulin E IgE to the relevant occupational allergen)Adhesives, Metals (chemical coolants), Resins, Isocyanides, Flour and grain dust, Latex, Animals (shellfish in particular), Aldehydes, Wood dust whitethorn act as agents causing occupational asthma (3).Reactive airways dys function syndrome (3)The circumstance reactive airways dysfunction syndrome (RADS) refers to the development of a persistent asthma-like syndrome for at least three months following ingestion of an airway irritant. The onset of symptoms occurs after a single specific exposure to a gas, smoke, fume, or vapour in very high concentrations. It is aroundtimes referred to as irritant-induced asthma. The most commsolely reported agent causing RADS is Chlorine. Other commonly reported agents admit toluene diisocyanate, oxides of nitrogen, acetic acid, Sulphur dioxide, and certain paints.Occupational chronic obstructive pulmonary Disease (3)Chronic obstructive pulmonary disease (COPD) is an umbrella border that encompasses several different pathologies, most notably chronic bronchitis, small airways disease and emphysema, and is defined by airflow limitation that is usually progressive. Inhalation of noxious particles or gases encountered in an occupational setting make an important con tribution to COPD. roughly notably, these include coal dust, cotton textiles, welding vapours, cadmium and silica.Pneumoconiosis (4)The disease is caused by dust particles approximately 25m in diameter that are retained in the small airways and alveoli of the lung. The incidence of the disease is related to hit dust exposure, which is highest at the coal face, particularly if ventilation and dust suppression are poor.Coal-workers pneumoconiosis (3), (4)Coal workers pneumoconiosis (CWP) results from the inhalation of particles of coal mine dust, which are engulfed by macrophages which then accumulate to form the coal macule, characteristically located in the centrilobular region. Pneumoconiosis searchs on the chest roentgen ray as small rounded opacities, typically appearing in upper and middle zones. Simple coal workers pneumoconiosis is not associated with defective clinical signs or significant impairment of lung function. If shortness of breath and lung function impairment are present they are likely to be due to associated lung or flavour disease. Progressive massive fibrosis (PMF) refers to the coalescence of macules to form irregular masses of fibrous tissue. AsbestosisAsbestosis is a progressive disease that results from breathing in microscopic fibres of asbestos. These small fibres clear up over time and can cause scarring, or fibrosis, in the lungs. This scarring causes the lungs to stiffen and makes it hard to breathe or get enough oxygen into the blood.(5)Asbestosis may not show up until 10 to 40 years after exposure to asbestos fibres.(6)SilicosisSilicosis is a disabling, dust-related disease and is one of the oldest occupational lung diseases in the world. Silicosis is caused by exposure to and inhalation of airborne crystalline silica. Silica (SiO2) is the name of a group of minerals that are found in mines, foundries, blasting operations, stone, clay, and glass manufacturing. Dust particles from silica can penetrate the respiratory syst em and land on alveoli (air sacs).This causes scar tissue to develop in the lungs and impair the exchange of oxygen and carbon dioxide in the blood.(7)though symptoms of silicosis rarely develop in less than five years. Silicosis also makes a person more susceptible to infectious diseases of the lungs, such as tuberculosis.(7)ByssinosisThe symptoms start on the first day back at work after a break (Monday sickness) with improvement as the week progresses. Tightness in the chest, cough and breathlessness occur within the first hour in dusty areas of the mill, particularly in the blowing and carding rooms where raw cotton is cleaned and the fibres are straightened. The most likely aetiology is endotoxins from bacteria present in the raw cotton causing constriction of the airways of the lung.BerylliosisBerylliumcopper alloy has a high tensile strengthand is resistant to metalfatigue, high temperature and corrosion. It is used in the aerospace industry, in atomic reactors and in many e lectrical devices. When beryllium is inhaled, it can cause a systemic illness with a clinical picture similar to sarcoidosis. The major chronic problem is that of progressive dyspnoea with pulmonary fibrosis.Hypersensitivity pneumonitisHypersensitivity pneumonitis (previously called extrinsic allergic alveolitis) refers to an allergic inflammatory pneumonitis following the repeated inhalation of organic material. workers at risk include those with exposure to mould or fungal spore in agriculture, horticulture, forestry, cultivation of edible fungi or malt working, those manipulation mould vegetables and those caring for or handling birds. The disease has two patterns the acute form and chronic form.Occupational respiratory crab lousesMesotheliomaThe most notorious occupational cancer in respiratory practice is pleural mesothelioma. Its occurrence almost invariably suggests past asbestos exposure which may expect been low level, and even bystander, exposure. The long response ti me between exposure and presentation suggests that the incidence of mesothelioma ordain continue to increase. Occupations associated with significantly higher mesothelioma deaths include plumbers, pipefitters, and steamfitters mechanical engineers electricians.pleural diseaseAsbestos-related pleural diseasePleural plaques are the most common manifestation of past asbestos exposure. They are discrete circumscribed areas of hyaline fibrosis found on mainly parietal pleura.Prevention of occupational lung diseasesAgent-Oriented Strategiesa. Environmental hazard surveillanceEfforts should be continued to be identify occupations in which workers are likely to have high incidence of occupational lung diseases. supernumerary guardianship should be given to environmental surveillance and exposure control. Environmental surveillance is the most in effect(p) content of identifying problem areas, directing control efforts, and later on measuring the impact of counteraction strategies.i. AsbestosOccupations where workers are more likely to be at high risk of exposure to asbestos needed to be set. Special attention should be given to environment surveillance and control of such occupations.ii. Cotton DustsIndustries using cotton that contain high levels of endotoxins should be identified and evaluated for possible excess intervention strategies or enactment or enforcement of more stringent dust standard.iii. SilicaOccupations where workers are more likely to be at high risk of exposure to silica needed to be identified. Any work sites (such as coal mines) where silica levels exceed the standard must be enforced by mine safety and health administration. b. Medical Hazard ObservationDisease surveillance is needed to estimate the prevalence of occupational lung disease. However, because of latency, the lack of treatments, and the progression of some occupational lung diseases after exposure is of limited practical value, and stress should be placed on environment surv eillance.Hospitals are potential source of data and should be requested to record work histories and to report occupationally related diseases in their discharge reports. Government reporting systems using local physicians and district health officers are potentially the most effective means of disease surveillance. The primary advantage using local physicians and district health is their familiarity with local industry and the medical community. Involvement of local county health departments would also facilitate follow-up of reported cases. However this surveillance method has several difficulties, the most significant being the unwillingness of physicians and workers to report disease because of the potential for litigation and comebacks. c. Hazard RemovalFor many hazardous substances, control measures are difficult or un on tap(predicate). However substitute materials are often on hand(predicate) for hazardous substances and should be used.i. AsbestosA rule-making change shoul d be under taken by health authorities to require that a dust control and monitor plan for all operations with likely asbestos exposure be filed for approval before any work is done in site, Implicit in this requirement would be sound justification for the use of asbestos as opposed to alternative materials. Nonessential uses would not be approved.ii. Cotton DustsRecommended cotton dust level for work places is 0.2mg/m3. Industries in which workers show acute reactions at dust level below 0.2mg/m3 should consider the use of cotton substitutes or lower dust levels.iii. SilicaBecause effective controls for silica in abrasive blasting operations have not be demonstrated, silica should be banned as abrasive blasting material. in stock(predicate) silica substitutes that have been shown to be nontoxic should be used.Exposure-Oriented Strategies a. Control TechnologyMany exposure control measures are available, such as engineering fancy and automation, ventilation, substitution, isolati on, and changes in work practices.Technology transfer and implementation goals should be established, so that both workers and management are familiar with control technology and its application. b. regulative EnforcementRegulatory enforcement is the most effective element in the strategy to prevent occupational lung disease. Many acts (such as Mine rubber and Health Act and Occupational Safety and Health Act) place the responsibility for providing a safe and healthful work place directly on the shoulders of employer. Other measures of enforcement include sampling requirements for operators, an inspector take stock programme, pre-operational filling hazard control plans and the right for inspectors to unsafe operations onsite.i. AsbestosEvidence indicates that the current asbestos standard provides only partial protection from asbestos-related diseases. Particularly cancer. The present permissible exposure limit (PEL) should be reduced to recommended concentration of 100,000 fib res/m3 since that is the lowest level of exposure that can be accurately measured using currently available analytical techniques.ii.SilicaOnce silica exposure is recognized, control could be accomplished in particularly every instance. The most effective measure for silicosis is preventing hazardous exposure, through strict enforcement of an appropriate exposure standard. Present federal standard based on percent silica range from allowable exposure of 33g/m3 to 98 g/m3 free silica. These levels should be unified to a single standard that provide protecting against silicosis over working lifetime.iii. Coal DustMost effective prevention strategy for Coal-workers pneumoconiosis is declining coal dust level to 2mg/m3. In addition efforts should be made to increase the awareness of dust control techniques among small-scale operations. c. Education and TrainingAn education program must be targeted to future engineers and managers to increase the appropriate use of control techniques. In volvement should be directed toward schools of engineering, public health, business, and vocational education. The occupational health skipper must also trained and actively involved as a change agent in trying to improve working environments and developing advised worker and management groups.The educational program of occupational health professionals should include special emphasis on epidemiology, biostatistics, industrial sanitation and safety, toxicology, and occupational health. Professionals need to learn what the work environment is, how to assess the work exposure, and how to control them. Proper use of engineering controls and professional protective devices is necessary component of such education.Government and local health departments can offer a ready source of expertise such as physicians, nurses, sanitarians, epidemiologists. These departments and primary care physicians should be used to identify small and local plant problems. Primary care physicians should be t aught to recognize work related diseases as part as of their medical training. d. Incentive SystemsAlthough workers compensation lows do provide some financial relief for disabled workers, they are essentially applied only after existing prevention system have failed and when physical therapies are non-existent. For this reason, and because the individual state compensation lows are diverse, significant modifications to present system will not be achievable as part of prevention strategy.Economic incentives, such as lower insurance premiums, should be explored as a means for industry to implement new controls. e. RespiratorsRespirators and other personal protective devices should not be considered a primary control mechanism because they depend on gentlemans gentleman intervention.Worker-Oriented Strategies a. Health Promotion and SmokingSmoking is strongly associated with many lung diseases, including chronic bronchitis, emphysema, and lung cancer. Moreover, roll of tobacco has a n additive effect on risk for chronic bronchitis in workers exposed to coal mine and other dusts, and it acts synergistically with asbestos to increase the risk of lung cancer. So that management and workers should work together to develop appropriate non-smoking policies such as prohibit smoking at work places with sufficient disincentives for those who do not comply, Distribute information on health promotion and the harmful effects of smoking and etc. b. Worker Knowledge of Exposure and Control Measures Workers should be specifically informed of the hazards to which they are exposed and the control measures available. This should be accomplished by employers distribution information to employees and by public education at school level. Workers right to know lows should be enacted to ensure that workers exposed to hazardous substances, such as silica and asbestos, are informed and aware of the importance of control measures. c. Disease SurveillanceDisease surveillance oriented tow ard the worker is design to discover those workers who may be at increased risk if exposure continues. This increased risk may result from pre-existing condition, early development of disease, or hyper susceptibility to a particular agent. When these workers are identified some form of intervention is warranted, usually involving a reduction of further exposure.Control Occupational Lung DiseasesFor some diseases there is no treatment other than better the patients current health and preventing further exposure.Early detection of occupational lung disease is often difficult, in part because in many cases, the potential period is long (eg, 15years for chronic silicosis and over 30 years for some asbestos related cancers). In addition, symptoms are often nonspecific and may not appear till disease well advanced.01. Management of occupational asthmaApproximately two-thirds of patients dont achieve full symptomatic healing and approximately three-quarters have persistent non-specific b ronchial hyper responsiveness. After the diagnosis nearly one third of the patients with OA are unemployed up to few years.02. Management of MesotheliomaThe therapy is focused towards relieving of symptoms. Highly selected patients can be prepared for radical surgery. Also the chemotherapy gives a small survival benefit of nearly three months. Pleural effusions can be managed with drain age and pleurodesis.03. Management of SilicosisAll the patients who suffer from silicosis should be screened for active or latent tuberculosis infection. They are also evaluated for other tuberculosis risk factors. (Eg HIV infection). at that place was no drug has been found to stop the progression of disease.04. Management of hypersensitivity pneumonitisTreatments include be away from source of the exposure and eradication of any residual antigens to prevent re-exposure. Self-limited exposure or if the exposure is short term complete recovery can be expected from most of the patents. But the patien ts with long term exposure will suffer from permanent damage to the lungs.