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The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement
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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Thoracic Society
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543721/ https://www.ncbi.nlm.nih.gov/pubmed/31149852 http://dx.doi.org/10.1164/rccm.201904-0717ST |
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author | Blanc, Paul D. Annesi-Maesano, Isabella Balmes, John R. Cummings, Kristin J. Fishwick, David Miedinger, David Murgia, Nicola Naidoo, Rajen N. Reynolds, Carl J. Sigsgaard, Torben Torén, Kjell Vinnikov, Denis |
author_facet | Blanc, Paul D. Annesi-Maesano, Isabella Balmes, John R. Cummings, Kristin J. Fishwick, David Miedinger, David Murgia, Nicola Naidoo, Rajen N. Reynolds, Carl J. Sigsgaard, Torben Torén, Kjell Vinnikov, Denis |
author_sort | Blanc, Paul D. |
collection | PubMed |
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. |
format | Online Article Text |
id | pubmed-6543721 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | American Thoracic Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-65437212020-06-01 The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement Blanc, Paul D. Annesi-Maesano, Isabella Balmes, John R. Cummings, Kristin J. Fishwick, David Miedinger, David Murgia, Nicola Naidoo, Rajen N. Reynolds, Carl J. Sigsgaard, Torben Torén, Kjell Vinnikov, Denis Am J Respir Crit Care Med American Thoracic Society Documents 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. American Thoracic Society 2019-06-01 2019-06-01 /pmc/articles/PMC6543721/ /pubmed/31149852 http://dx.doi.org/10.1164/rccm.201904-0717ST Text en Copyright © 2019 by the American Thoracic Society |
spellingShingle | American Thoracic Society Documents Blanc, Paul D. Annesi-Maesano, Isabella Balmes, John R. Cummings, Kristin J. Fishwick, David Miedinger, David Murgia, Nicola Naidoo, Rajen N. Reynolds, Carl J. Sigsgaard, Torben Torén, Kjell Vinnikov, Denis The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement |
title | The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement |
title_full | The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement |
title_fullStr | The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement |
title_full_unstemmed | The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement |
title_short | The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement |
title_sort | occupational burden of nonmalignant respiratory diseases. an official american thoracic society and european respiratory society statement |
topic | American Thoracic Society Documents |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543721/ https://www.ncbi.nlm.nih.gov/pubmed/31149852 http://dx.doi.org/10.1164/rccm.201904-0717ST |
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