Smoking and occupational lung diseases Flashcards
What are some of the harmful components of tobacco smoke, and how can they affect health?
Tobacco smoke contains carcinogens, which can lead to genetic mutations and increase the risk of lung cancer and mesothelioma. In addition, carbon monoxide (CO) in tobacco smoke can form carboxyhemoglobin, which can impair oxygen delivery to the body. Tobacco smoke can also impair ciliary function, leading to increased susceptibility to respiratory infections, and hyperplasia of goblet cells, leading to increased mucus production.
What are some of the health conditions that are associated with smoking?
Smoking is associated with increased risk of lung cancer, mesothelioma, bladder cancer, renal cell cancer, chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), peripheral vascular disease (PVD), ischemic heart disease (IHD), cerebrovascular accidents (CVA), and fetal growth retardation.
How does nicotine in tobacco smoke lead to dependence and withdrawal?
Nicotine in tobacco smoke binds to nicotinic acetylcholine receptors in the brain, leading to the release of neurotransmitters that can increase pleasure, reduce anxiety, and decrease appetite. Over time, this can lead to dependence on nicotine. When a person stops smoking, they may experience physical and psychological withdrawal symptoms.
What are the 5 A’s of smoking cessation?
The 5 A’s of smoking cessation are: Ask, Advise, Assess, Assist, and Arrange. These steps involve identifying smokers at every visit, advising every patient who smokes to quit, assessing their willingness to quit, providing access to counseling and prescribing pharmacotherapy, and arranging follow-up.
What is the evidence that supports smoking cessation?
There is strong evidence that smoking cessation improves morbidity, mortality, and is cost-effective. Brief advice from a GP has been shown to help 2% of smokers quit, which translates to 75,000 people. Other effective smoking cessation interventions include “Quitline” or NHS Stop Smoking Services, smoking bans in public places, and smoking cessation clinics.
What is Nicotine Replacement Therapy (NRT), and how does it help with smoking cessation?
NRT is a form of treatment that provides nicotine in a slower and safer way than cigarettes, without the tar, CO, or carcinogens. NRT comes in various forms, including patches, gum, nasal spray, inhalator, and e-cigarettes. Clinical trials have shown that NRT doubles the chance of success of smokers wishing to stop, and reduces withdrawal symptoms such as irritability, depression, and cravings. Very few people become addicted to NRT.
What are some other treatments that can help with smoking cessation?
Other treatments that can help with smoking cessation include
bupropion (Zyban), which is an anti-depressant that increases dopamine levels
varenicline (Champix), which binds to the neuronal nicotinic Ach receptor as a partial agonist and is the most effective treatment for smoking cessation.
Hypnosis and acupuncture are alternative treatments that may also be helpful for some people.
What are some characteristics of occupational lung diseases?
Occupational lung diseases can have a long latency period, which means it can take decades from the time of exposure to the onset of symptoms
What are some types of occupational lung diseases?
Types of occupational lung diseases include occupational asthma, malignant diseases such as lung cancer and mesothelioma, and pneumoconiosis caused by mineral dust such as coal workers’ lung, asbestosis, and silicosis.
What information is important to obtain when taking a history of occupational lung disease?
it is important to obtain a detailed history of all occupations, including the type of material used, duration and intensity of exposure, temporal relationship to onset of symptoms, and availability of masks. It is also important to obtain a history of lung disease, smoking history, and symptoms both at work and away from the workplace.
How has the approach to preventing occupational lung disease changed over time?
The approach to preventing occupational lung disease has improved over time, with increased awareness of the risks and better safety measures in place. Employers are now accountable for providing safe work environments, and wearing masks is now common in many workplaces. Asbestos, a common cause of occupational lung disease, has been banned.
What is occupational asthma, and how does it differ from work-exacerbated asthma?
Occupational asthma is the most common occupational lung disease, and it can develop for the first time when an individual is exposed to an irritant or sensitizer at work. Work-exacerbated asthma, on the other hand, is pre-existing asthma that is made worse by workplace exposures.
What are some common causes of occupational asthma in different industries?
Occupational asthma can be caused by various irritants or sensitizers in different industries.
What are some features of occupational asthma, and how is it diagnosed?
Occupational asthma is characterized by breathlessness and wheezing in the workplace, which improve when away from that environment. Reduction in peak flow and spirometry at work may also occur.
What are some management strategies for occupational asthma?
Management of occupational asthma involves identifying the allergen or agent causing bronchoconstriction if possible, and implementing workplace measures such as a health and safety review by the employer, appropriate masks (FFP3), adequate ventilation, removing the individual from areas with increased risk, and re-deploying if necessary. Personal measures such as smoking cessation and optimum asthma management can also be helpful. If the employer is found to be negligent, the affected worker may be eligible for compensation.
What is pneumoconiosis
Pneumoconiosis is a lung disease caused by inhalation of various inorganic particles and mineral dust particles at work.
What are some examples of inorganic particles and mineral dust particles that can cause pneumoconiosis?
Examples of particles that can cause pneumoconiosis include coal, asbestos, silica, siderosis (from iron and steel), talc, beryllium, tin, barium, and cobalt.
How do different types of dust particles affect the development of pneumoconiosis?
Different types of dust particles require different concentrations to cause disease. For example, coal dust requires a high concentration to cause disease, while silica or asbestos require lower concentrations to cause fibrosis.
How is pneumoconiosis diagnosed and treated?
Diagnosis of pneumoconiosis involves a detailed occupational history, physical examination, chest x-ray, and pulmonary function tests. Treatment options are limited, but may include smoking cessation and oxygen therapy.
What is progressive massive fibrosis (PMF), and what are some symptoms?
PMF is a type of pneumoconiosis that can cause breathlessness, cough, and weight loss, and can even lead to death.
What are some occupations at risk for developing silicosis?
Occupations at risk for developing silicosis include slate workers, potters, knife grinders, hard rock miners (gold, tin, iron, uranium), sand-blasting, stone cutting, and foundry workers.
