Occupational risk factors
‘Occupational risk factors’ is a term used to describe the harmful effects of breathing in various particles, gases, fumes or smoke in the workplace. These different factors are often referred to as ‘agents’.
What is it?
Workplace guidelines exist in the European Union to ensure that there are limits on known harmful agents. These are decided by the European Commission’s Scientific Committee on Occupational Exposure Limit Values (SCOEL). Ensuring safe levels of a number of dangerous agents is an on-going challenge.
This chapter will provide information about the main triggers and causes of work-related lung diseases. Visit each disease section for more information on the symptoms and treatment of work-related lung diseases.
The effects of exposure to agents in the workplace can lead to a number of different lung-related diseases and short-term problems. The damage caused by exposures varies between people and is dependent on the time of exposure, the level of exposure and other factors, such as whether the person smokes or has any pre-existing conditions or if they use protective equipment at work.
For some agents, a high level of exposure over a long period is needed to cause a lung condition. However, exposure to some materials (e.g. asbestosis) for a few weeks may cause disease years later.
Asthma is the most common condition caused by factors at work. Occupational risk factors can also aggravate existing asthma.
Between 350 and 400 different agents are known to cause occupation asthma. These include agents from vegetables or animals and agents from metals, dyes and chemicals.
Some of the main agents include:
- Acarians (ticks, mites)
- Aromatic amines
- Biological enzymes
- Crustacea, seafood, fish
- Quaternary amines
- Reactive dyes
- Plant-derived natural products
- Wood dust or bark
- Various chemicals
- Vegetable gums
- Aliphatic amines (ethyleamines and others)
15-20% of COPD is thought to be linked to occupational exposures. This is due to exposure to mineral dusts, irritant gases or vapours in the air. Click on the table below to see a list of agents which may lead to COPD.
Occupational lung cancer
A huge variety of industries and occupations can increase the risk of lung cancer, however most occupational lung cancers are caused by asbestos. Research has discovered various agents linked with lung cancer – some with limited evidence and others with sufficient evidence to suggest a link.
Occupational pleural disease (including mesothelioma)
Pleural disease is almost exclusively linked to exposure to asbestos. Although asbestos-use is now illegal, people who were exposed to the condition at a young age are living with the illness in old age as symptoms of the disease may take up to 50 years to appear.
Acute inhalation injuries
This occurs from a single incident resulting in a sudden and large exposure to a material, such as a chemical spillage, fire, gas explosions or exposure to large amounts of dust.
It is caused by exposure to irritant gases, such as ammonia, ozone or chlorine, organic chemicals such as tear gas or mustard gas, metallic compounds such as mercury vapour or metal fumes, or complex mixtures of gases and particles such as solvent mixtures or fire smoke.
These infections occur from exposure to bacteria and include tuberculosis (TB), Q Fever, severe acute respiratory syndrome (SARS), Measles and Legionnaires Disease.
The main group of people at risk are healthcare professionals treating the conditions in others.
Occupational interstitial lung diseases
There are a number of rare interstitial lung diseases linked with occupational exposures. These conditions are broadly known as pneumoconiosis and include well-known causes such as coal, asbestos and dust and other less-known causes such as crystalline silica, titanium and aluminium.
Another important interstitial lung disease is extrinsic allergic alveolitis, caused by an allergic reaction to an agent. Causes can include droppings and feathers from birds, humidified water from air conditioning systems, bacteria in the mist from hot tubs, and mouldy agents such as sawdust, cheese, hay, straw or grain.
Exposures to particles, gases, fumes or smoke in the workplace are responsible for:
- 15% of all respiratory cancers in men and 5% in women
- 15-20% of all adult asthma cases
- 15-20% of chronic obstructive pulmonary disease (COPD) cases
- 10% of all interstitial lung disease cases
Current and Future Needs
National and international bodies set maximum allowable workplace concentrations for a wide range of substances. However, these limits are not usually set at a level that can avoid an individual developing an allergy to the agent. In the future, workplace limits should take into account what levels of agents can cause allergies, in addition to occupational diseases. As new agents are identified they should be swiftly regulated.
If an occupational condition is expected, healthcare professionals should take note of every job since a patient started work as some diseases are latent with symptoms not appearing for a number of years.