Emerging Issues in Environmental and Occupational Lung Diseases

Humans continue to introduce new or greatly modified agents and techniques into the workplace and environment. These new agents and altered practices lead to evolving patterns of established diseases as well as entirely novel conditions never experienced before in medical history. Although many of these emerging conditions appear in the literature as case reports or case series, these sentinel cases frequently raise the public awareness that drives social movements or, in some situations, represent a warning sign for subsequent outbreaks. The emerging environmental and occupational lung diseases (EOLD) may be grouped arbitrarily into two categories: (1) conditions caused by novel utilization or routes of exposure to agents known to cause EOLD and (2) conditions caused by novel agents not known to cause specific EOLD in the past. Conditions in the first category may include those caused by new exposure scenarios in nonindustrial settings and thus a large population may be at risk. The second category includes new risk factor(s) that were not known to be associated with a specific EOLD, and thus the association between the agent and the new condition could be easily missed. Clinicians should remain astute and vigilant when evaluating the potential role of environmental risk factors in any lung diseases and especially pay attention to the identification of clusters of cases of disease of unknown etiology.