Symposium Addresses Occupational Lung Diseases

Occupational lung diseases have long challenged physicians, but expert speakers in Monday morning’s symposium on “Surveillance, Early Detection, and Prevention of Occupational Lung Diseases” will give ATS International Conference participants an in-depth look at a wide range of conditions and disease. The program will be from 8:15 to 10:45 a.m. in Grand Ballroom E (Level 5) Philadelphia Marriott Downtown.

The program will delve into recent findings and state-of-the art approaches to occupational health surveillance for work-related airway diseases and pneumoconiosis, considerations in designing a health surveillance program for workers exposed to emerging occupational respiratory hazards before adverse health effects have been fully documented, a literature review of spirometry, and an update on respiratory protection in the occupational setting.

“Many pulmonary clinicians, not just those who routinely do occupational work, will benefit from informative updates on detecting occupational respiratory diseases from world-famous experts,” said ATS Environmental & Occupational Health Assembly Chair Paul Henneberger, MD, a research health scientist in the Division of Respiratory Diseases Studies at the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health.

Symposium Co-moderator Susan Tarlo, MBBS, professor of medicine at the University Toronto and in the Dalla Lana School of Public Health, will present background on medical surveillance for detecting asthma, COPD, and constrictive broncholitis during “Medical Surveillance for Occupational Airways Disease.” In particular, she will examine the need for more formal assessment and opportunities for surveillance for screening for occupational airway diseases.

Well known for his publications on lung diseases suffered by coal miners, Edward Petsonk, MD, professor of medicine at West Virginia University, Morgantown, will present “Update on Medical Surveillance for Workers at Risk for Pneumoconiosis,” which will include a look at recent advances in detection technology.

Changes in coal mining production, such as the use of more powerful machines that produce more coal more rapidly, have brought about changes in the incidence of the disease.

“After a period of declining rates of black lung disease, we are now finding more cases in younger people and cases that are more severe,” said Co-Moderator David Weissman, MD, director of the Division of Respiratory Disease Studies and manager of the respiratory diseases research program at the CDC’s NIOSH.

Dr. Weissman is particularly interested in how recent years have brought on the recognition of new respiratory conditions. He will delve into some during “Occupational Respiratory Disease Surveillance for Workers Exposed to Emerging Hazards: What Have We Learned?”

“We’ve had a number of transformative kinds of things happen that have changed the way we think,” said Dr. Weissman, pointing to lung disease derived from butter flavoring, flock worker’s lung disease caused by cutting nylon threads, nano particle exposure resulting in lung disease, and returning veterans presenting with constrictive bronchiolitis. “We cannot dismiss the risk of potential occupational exposures, and multidisciplinary engagement is important for all these problems. For example, it’s important to engage experts like industrial hygienists to understand exposures and toxicologists to study causality of exposures.”

Carrie Redlich, MD, MPH, professor medicine and director of the occupational and environmental medicine at Yale School of Medicine, will then present “Spirometry in the Occupational Setting: Lessons from a Systematic Review of the Literature.” Drs. Redlich and Tarlo are co-chair of a panel that reviewed the literature.

“Dr. Redlich will share some of the key findings from a panel review of the literature and the panel’s consensus that’s being developed into a statement. While the statement is in draft form, we thought it timely to bring out some of the results,” said Dr. Tarlo, who is among the panel members with Dr. Weissman.

“When spirometry is being used, it’s important to look beyond the results at a particular point in time for a worker, but also where the worker started,” Dr. Tarlo said.

For example, an FEV1 of 95% predicted is considered normal, and a worker who does heavy labor and is extremely healthy presenting with the same percentage would also seem normal. However, this worker may have started with an FEV1 of 120% predicted and have lung function that is in rapid decline.

“If there’s enough data, one can project to some extent a later problem. That allows one to intervene earlier and to make changes in the workplace to protect other workers,” Dr. Tarlo said.

The program will wrap up with Philip Harber, MD, MPH, professor of public health at the University of Arizona, Tucson, who will share his insights in his “Update on Respiratory Protection in the Occupational Setting.”

“Pulmonary practitioners frequently have to deal with respiratory protection, but unless they have an occupational orientation they often don’t get a lot of background about that,” Dr. Weissman said. “Dr. Harber will talk about this important preventive measure for patients exposed to a respiratory hazard, such as how to select the right respirator and how to make sure that it fits and functions properly.”

“This symposium addresses early detection of respiratory disease so practitioners can intervene early, and also so they can identify problems in workplaces and provide public health interventions to the entire workplace.”