The butcher, the baker, and the candlestick-maker have more
in common than a romp in the tub. People in these and a much wider variety
of occupations than often suspected are at risk of developing respiratory
injury or disease in the work place, says a University of Rochester
physician in an article in the Feb. 10 issue of the New England Journal of
Medicine.
"It used to be that mainly coal miners or people who worked with asbestos
were the ones who came to doctors with lung disease from the work place,"
says author William Beckett, M.D., professor of environmental medicine. "But
today, conventional work places like hospitals or construction sites are
just as likely to cause respiratory disease. There's been a tremendous
amount of new information pouring out in recent years; doctors may see such
patients and not realize the cause."
Respiratory problems caused by the work place can range from a stuffy
nose, sinusitis or laryngitis, all the way to allergies, asthma, emphysema
and lung cancer. The butcher (fumes from plastic wrap), the baker (mites and
fungi hitching a ride on grain dust), and the candlestick-maker (fumes) mark
just a few of the occupations that can cause respiratory distress. More
common culprits include latex gloves, dust kicked up during construction,
and everyday cleaning solutions.
While employees in certain occupations know the risks, others don't. The
latter group often includes construction workers, says Beckett. Just as coal
miners are at risk of developing respiratory diseases from dust, so are
construction workers who break down rocks and move earth as part of highway
or building construction.
In hospital or pharmaceutical laboratories, employees have higher rates
of asthma because of the latex gloves they wear. A physician at the
University of Toronto Medical Center has found that it's the cornstarch
powder, added to make the gloves easier to pull on and off, that causes the
problem by carrying latex particles into the nose and lungs. Powder-free
gloves there have helped reduce asthma among workers. "It's often a very
simple technological fix that solves these problems," Beckett says.
Asthma can also be a problem for roofers. As part of the sealing process,
roofers now use polyurethane foam, which can provoke asthma. The same
material in paints is the reason why auto-body shops are home to the largest
number of work-place-induced asthma cases in the United States, Canada and
United Kingdom, according to Beckett. He says that most shop operators know
the risks and have installed special ventilation systems and wear
respirators.
In addition to such patients, Beckett says that nearly every pulmonary
physician in the North, where asbestos was once used widely to insulate
houses and pipes, has patients who are now developing asbestos-related lung
diseases. These patients make up the best-known group of people who have
permanent lung injury from their work. Such workers are at much higher risk
of developing lung cancer or fibrosis, where the lungs become hard and
aren't able to absorb oxygen efficiently.
Other lines of work that put workers at higher risk of respiratory
disease include:
. Farm work. Farmers are susceptible to "silo filler's disease," caused
by freshly stored hay that gives off a gas that can be dangerous.
Agriculture workers are also prone to developing allergies to molds that
grow in hay bales.
. The seafood industry. Crabs and other crustaceans can cause asthma.
. The food industry. Mites and fungi often piggyback onto food dust and
can infiltrate the lungs, causing allergies and asthma.
. Hospitals. The chemicals used to sterilize instruments can sometimes
cause allergies.
. Janitorial services. Custodians can be exposed to dangerous gases if
they mix bleach with common detergents.
. Manufacturing. Cleaning products, paints and other chemicals can cause
allergies and asthma.
. Tool Fabrication. The grinding releases particles of elements such as
cobalt that can cause respiratory disease in tool-makers.
Beckett says doctors should consider the work place as a possible cause
for any unexplained lung ailment in a working adult, and they should check
if symptoms ease after work or during weekends or vacations. Even so,
oftentimes a person's illness has nothing to do with the work place, even
though circumstances might make a doctor suspect a link. One patient Beckett
saw had developed a serious lung ailment caused by molds that often grow in
the type of metal-working fluids she was exposed to in her job at a
manufacturing plant. A little bit of detective work located the real source
of the problem: fiberglass insulation in her basement that had become home
to a large colony of mold.
"What's important to realize is that most work sites are very safe and
very healthy. But if a patient is having a respiratory problem, the
physician should consider the patient's work place when looking for the
cause of illness," says Beckett, whose work is supported by the National
Institute of Environmental Health Sciences.
This story has been adapted from a news release issued by University
Of Rochester |