The Occupational Burden of Nonmalignant Respiratory Diseases: An Official American Thoracic Society and European Respiratory Society Statement

Details

• Personal Author:
  Annesi-Maesano I ; Balmes JR ; Blanc PD ; Cummings, Kristin J. ; Fishwick D ; Miedinger D ; Murgia N ; Naidoo RN ; Redlich CA ; Reynolds CJ ; Sigsgaard T ; Torén, Kjell ; Vinnikov D
• Description:
  Rationale: Workplace inhalational hazards remain common worldwide, even though they are ameliorable. Previous American Thoracic Society documents have assessed the contribution of workplace exposures to asthma and chronic obstructive pulmonary disease on a population level, but not to other chronic respiratory diseases. The goal of this document is to report an in-depth literature review and data synthesis of the occupational contribution to the burden of the major nonmalignant respiratory diseases, including airway diseases; interstitial fibrosis; hypersensitivity pneumonitis; other noninfectious granulomatous lung diseases, including sarcoidosis; and selected respiratory infections. Methods: Relevant literature was identified for each respiratory condition. The occupational population attributable fraction (PAF) was estimated for those conditions for which there were sufficient population-based studies to allow pooled estimates. For the other conditions, the occupational burden of disease was estimated on the basis of attribution in case series, incidence rate ratios, or attributable fraction within an exposed group. Results: Workplace exposures contribute substantially to the burden of multiple chronic respiratory diseases, including asthma (PAF, 16%); chronic obstructive pulmonary disease (PAF, 14%); chronic bronchitis (PAF, 13%); idiopathic pulmonary fibrosis (PAF, 26%); hypersensitivity pneumonitis (occupational burden, 19%); other granulomatous diseases, including sarcoidosis (occupational burden, 30%); pulmonary alveolar proteinosis (occupational burden, 29%); tuberculosis (occupational burden, 2.3% in silica-exposed workers and 1% in healthcare workers); and community-acquired pneumonia in working-age adults (PAF, 10%). Conclusions: Workplace exposures contribute to the burden of disease across a range of nonmalignant lung conditions in adults (in addition to the 100% burden for the classic occupational pneumoconioses). This burden has important clinical, research, and policy implications. There is a pressing need to improve clinical recognition and public health awareness of the contribution of occupational factors across a range of nonmalignant respiratory diseases. [Description provided by NIOSH]
• Subjects:
  Asthma Environmental Exposure Fibrosis Health Personnel Inhalation Exposure Lung Lung Diseases Occupational Health Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety Silicon Dioxide Tuberculosis Workplace

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• Keywords:
  Airway Obstruction Author Keywords: Interstitial Fibrosis Bronchial Asthma Chronic Obstructive Pulmonary Disease COPD Exposure Levels Hazards Health Care Workers Hypersensitivity Pneumonitis Inhalants Lung Disease Lung Disorders Nonmalignant Respiratory Diseases Occupational Pneumonia Pneumonitis Respiratory Diseases Respiratory Infections Risk Factors Sarcoidosis Silica Statistical Analysis TB Work Environment Workers Workplace

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• ISSN:
  1073-449X
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  California ; Connecticut ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 9 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  199
• Issue:
  11
• NIOSHTIC Number:
  nn:20056057
• Citation:
  Am J Respir Crit Care Med 2019 Jun; 199(11):1312-1334
• Contact Point Address:
  Paul D. Blanc, M.D., M.S.P.H., University of California, 350 Parnassus Avenue, Suite 609, San Francisco, CA 94143
• Email:
  paul.blanc@ucsf.edu
• CAS Registry Number:
  Silica (CAS RN 7631-86-9)
• Federal Fiscal Year:
  2019
• Peer Reviewed:
  True
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:fefb26d3f662ea06b07dbdb0927285684b2fdd64c296ec8bdac5c16106613a284fb4ec9d93f761810c14b8f74d9fe813fecdb0510cfc1baa1e0e03d5f3a19d13
• Download URL:
  https://stacks.cdc.gov/view/cdc/213754/cdc_213754_DS1.pdf
• File Type:
  [PDF - 1.08 MB ]