occupational lung disease Flashcards
what is the aim of occupational health
to promote and maintain the highest degree of physical, mental and social well being of workers in all occupations by preventing departures from health, controlling risks and adapting work to people
3 important legislations in occupational health
health and safety at work act (1974); control of substances hazardous to health (COSHH - 2002); report of injuries, disease and dangerous occurences at work (1995)
where do most occupational deaths occur (location)
offshore
10 examples of occupational lung diseases
asbestos related; occupation asthma; pneumoconiosis; byssinosis; berryllium disease; lung cancer; hypersensitivity pnuemonitis; infections; COPD
why might occupational lung diseases be under reported
people afraid if they report they will be told to stop working - they would be out of a job
what industries are highly susceptible to occupational lung diseases
construction; engineering; welding; foundries; mechanics; stonemasons; farmers
what is the largest single cause of work related fatal disease in the UK
asbestos
6 consequences of asbestos exposure (symptoms)
pleural plaques; diffuse pleural thickening; malignant mesothelioma; asbestosis; lung cancer; laryngeal cancer
what asbestos has the greater ability to reach alveoli
crocidolite (blue)
what are the types of asbestos
crocidolite (blue); amosite (brown); chrysotile (white)
what length of fibres are more resistant to phagocytosis clearance
> 5µm
when does asbestosis typically present
several decades following exposure
what fibres are usually seen in the lungs of those with asbesotsis
chrysotile
work aggravated vs irritant induced asthma
work aggravated - irritant provokes symptoms of pre-existing asthma;
irritant induced - asthma which is caused by inhaling a substance hazardous to heath in the workplace (reactive airways dysfunction syndrome)
3 levels of exposure that can result in irritant induced occupational asthma
- single exposure to high level irritant substance;
- multiple high-level exposures;
- chronic moderate-level exposure (more delayed symptom onset)
3 levels of exposure that can result in irritant induced occupational asthma
- single exposure to high level irritant substance;
- multiple high-level exposures;
- chronic moderate-level exposure (more delayed symptom onset)
what is sensitiser induced occupational asthma
asthma caused by immunological sensitiation to agents in the workplace (T1 hypersensitivity)
who should occupational asthma be reported to (and due to which act)
to Health and Safety Executive (HSE) under RIDDOR
what is key to the history of occupational asthma
improves over weekends/ holidays (although this pattern may be lost over time)
examples of causes + associated occupations for occupational asthma
cleaning agents - cleaners
flour - bakers
animals - lab workers
latex - healthcare
wood dust - carpentry
persulfate salts (hairdressers)
isocynates - paint spraying
investigations for occupational asthma (5)
specific inhalation challenge; workplace challenge; history (improvement over holidays); serial peak flow; RAST (look for specific IgE)/skin prick testing
treatment for occupational asthma
same as regular asthma (start with SABA reliever and low dose ICS preventer)
hierachy of control measures (pyramid bottom to top, 4)
PPE -> administrative controls (relocation to a different job/work area) -> engineering controls (encolse work processe etc.) -> elimination or substitiution
if your pt doesn’t want to inform their employer about occupational asthma diagnosis can you inform their employer
no - confidentially cannot be breached in this case
