Occupational Lung Disease : Causes, Treatment, Side effects, Costs and Alternatives

An occupational disease is a health problem caused by exposure to a workplace health hazard. An occupational lung disease is a type of Occupational disease which effects the lungs. An occupational lung disease occurs usually as a result of inhalation of chemicals, dust particles, or proteins which tend to be harmful to the system. The severity and details of the disease depend primarily on the materials inhaled and the duration of the exposure, along with the amount inhaled. While it is most common in people who are employed in industrial jobs, it also impacts those who are indirectly exposed to these substances. The development of the modern era and the increase in industrialisation has seen a significant increase in these diseases although there are records of their occurrence dating back to the time of the Ancient Greeks and Romans. In particular, the term “Pneumoconiosis” is used while referring to lung diseases caused by the inhalation of mineral dusts.

The main type of Occupational lung diseases are as follows:

1. occupational asthma,
2. chronic obstructive pulmonary disease (COPD),
3. bronchiolitis obliterans,
4. inhalation injury,
5. interstitial lung diseases hypersensitivity pneumonitis, lung fibrosis
6. lung cancer and
7. mesothelioma.

The treatment usually begins when symptoms of the disease first begin to show in the patients. Symptoms of occupational lung disease include coughing, panting, shortness of breath while performing strenuous activities, chest pain or tightness, and abnormal breathing patterns. In many cases, the disease may be diagnosed only late into its development due to negligence or financial conditions.

The treatment options available are as follows:

• Diagnosis : Diagnosis of the disease may involve chest x-rays, PFTs, Bronchoscopy, lung biopsy, blood tests, and CT scans. Since a number of people facing occupational lung diseases are usually minimum wage workers, they may choose to take up work in such conditions with little to no thought about the long term impact upon their health. Even when the symptoms are diagnosed, many people may continue to work in such fields because of the same reason. Treatment is usually done as a method of preserving their health to the best possible extent, and immediate actions are suggested for maintaining it.
• Treatment: There is no treatment for lung disease caused due to prolonged exposure to Coal, silica and asbestos. The only course of action remains medication and preventive measures to improve the living conditions of the individual, and preventing any further exposure to harmful substances which may worsen their condition. The treatment for these diseases is usually limited to advising the patients to avoid further exposure to the disease causing agents, and to immediately quit smoking. Moreover, they are instructed to take greater care of their respiratory functions, and in some cases, to undergo further tests in order to understand the extent of the disease. For simple malignancies, they may be provided with medication to eradicate them, while in slightly more difficult cases medical procedures may be carried out. In general, the treatment is limited only to preventive measures and attempting to improve the future conditions of the patient, or optimizing their current situation.

The severity of the disease also contributes to the possible treatments which can be administered. Some of the treatment possibilities are as follows:

• If a patient has spent great amounts of time being exposed to harmful chemicals and inhaling the particles, treatment options may be ineffective or even dangerous.
• On the other hand, people with simple CWP or classic silicosis may often live the remainder of their life with little to no symptoms of the disease.
• Complicated CWP results in severe respiratory debilitation and in the worst cases, in death.
• People exposed to Asbestos tend to run high risks of having lung cancer or mesothelioma, where the life expectancy for the people is greatly reduced and less than 20 percent of them stand a chance of surviving for over 5 years. Even this is possible only with careful surveillance and immediate detection and treatment of malignancies. In accordance with current standards, all miners and people working in association with the industry are encouraged to undergo regular checks to monitor the levels of particle inhalation and maintain their respiratory health. Working along the same guidelines, any workers showing signs of CWP may transfer to departments with less exposure.
• All patients are also instructed to stop smoking immediately, and clinical treatments are administered. Most treatment trials for these diseases have not shown very positive results and clinical research is still underway.

Workers who are working in polluted environment like factories, industries, and mining areas and are facing symptoms like cough, breathing problems, chest pain, abnormal breathing etc. are eligible for the treatment. Not only workers, people who are living near the industrial areas are also prone for infection due to air pollution and thus can suffer from these symptoms. These people are also eligible for the treatment.

Patients who are not suffering from any of these symptoms while working in such environment or living in such environment are not eligible for the treatment. But it is advised to get tests done as in many cases the disease may go un noticed and can lead to complications in near future. Thus it is advised to get regular check-up done to rule out this disease.

There are no specific side effects that can be found for the treatment of occupational lung diseases other than improvements in the life of the patient. Since one of the main instructions for them include quitting smoking, there may be certain amount of withdrawal symptoms such as headaches, fevers, chills, or shivering observed In the first few months. The treatment instructions may also lead to changes in the lifestyle and occupational choices of the individual. Since the aim of attempting to treat the disease is to reduce their discomfort, it does not have many negative side effects.

Post treatment guidelines usually involves preventing further exposure and distancing the patient from the source of the pollutants. In many cases, these treatment guidelines must be followed religiously for patients to improve their conditions. They are also instructed to attend regular sessions with their doctors, and have regular follow ups in order to assess the progression of the disease and identify any new issues or malignancies.

All people suffering from occupational lung disease have the freedom to cite regulations and request a change of department or reduction in their exposure to harmful particles. In some cases, the disease may have progressed to a point where any form of medication or treatment could cause further harm to their physical conditions. In such cases, they may be refused treatment and instead provided with support in social and moral forms.

Since the treatment of the disease is mainly a preventive measure and there is no major cure that has been identifies, the recovery time is essentially for increasing the quality of life of the individual. The recovery involves bringing them to optimal health and ensuring that health does not deteriorate further. The treatment shall be a process to enhance the health condition of the patient against the exposure to the pollution. Thus, the recovery time may vary from patient condition and the mode of the treatment opted. In some cases it can be a lifelong process and a lifelong supportive therapy in nature.

The price of treatment in India can range anywhere from a few hundreds to tens of thousands depending on the intensity of the disease and the levels of scans and tests which must be done before the diagnosis. Moreover, the cost also depends on the hospital or doctor who is approached and their specialization, educational qualifications, and experience. Moreover, if the lung disease requires follow ups or regular doctor visitations, the cost may increase substantially.

There are no permanent treatments of the disease, only those which can curb it from increasing or causing more discomfort. The main aim is to ensure that the disease is controlled. In cases where the occupational lung disease is at a very initial stage, diagnosis and treatment may ensure that it does not have any adverse effects. However, it is not possible to treat or repair already damaged respiratory organs, hence it is the goal of the treatment to prevent any further exposure to the irritant, prevent any worsening of the case, managing the symptoms and effects, and helping the patient stay as healthy and active as possible. Treatments and the extent of the treatment depend primarily on the type and extent of the disease.

There are no concrete alternatives to the treatment other than preventive measures. Since there are no medical treatments which have shown positive results, the only possible treatment is by preventing the disease from spreading further, and advising the patient to stay away from any more pollutants or minerals, as well as smoking or being receptors of second hand smoke, which may worsen their condition. The main aim of industries must be to control or annihilate the disease causing particles. There are certain cases which also suggest that early reports of gene therapy which result in anti-tumour responses may be the be a possible key to helping in the cure of mesothelioma. Similarly, research and study in the field of pulmonary fibrosis may help in curing asbestosis after adequate research and experimentation. Only when the underlying causes and mechanisms have been thoroughly understood can cures and preventive methods be implemented properly. This also involves increasing awareness among people who may not know about the harmful impact of the materials which are present in their work environments.