Occupational lung disease: A narrative review of lung conditions from the workplace

The role of imaging in the diagnosis of potential air pollution related illness: A narrative review

INTRODUCTION

The World Health Organization (WHO) emphasizes the global issue of poor air quality, largely attributed to the release of pollutants by human activity. In a significant development, air pollution was officially recorded as a cause of death in the UK for the first time in 2021, prompting the creation of the Clean Air Bill and campaigns to reduce emissions. In light of these developments, this paper aims to map available literature on air pollution-related illnesses, with a specific focus on the role of radiographic imaging in their diagnosis.

METHOD

A scoping review was conducted using the Scopus, Trip Medical Database, and CINAHL databases. Key terms such as "air pollution" and "imaging" and inclusion and exclusion criteria were applied. A critiquing framework assessed the quality, rigor, and transparency of research. Data from each study was extracted and extrapolated into a thematic matrix to display the results.

RESULTS

A review of ten papers comprising four systematic reviews, four cohort studies, and two longitudinal studies found nine different pollutants implicated in various diseases. Seven papers focused on brain pathological changes, two on lung function, and one on cardiovascular changes. Eight studies used Magnetic Resonance Imaging (MRI), and two used Computed Tomography (CT) scans.

CONCLUSION

The findings revealed nine different air pollutants were mentioned across a range of CT and MRI imaging modalities in the studies. Dementia was the most referenced illness. The results suggest that air pollution-related illnesses will continue to pose a significant health risk, impacting the general population and the clinical work of the radiography profession.

IMPLICATIONS FOR PRACTICE

Given the diverse effects of air pollutants on health, it is important radiographers are educated on how patient's history may influence imaging findings.

Therapeutic Approaches for the Treatment of Interstitial Lung Disease: An Exploratory Review on Molecular Mechanisms

BACKGROUND

Interstitial Lung Diseases (ILDs) are characterized by shortness of breath caused by alveolar wall inflammation and/or fibrosis.

OBJECTIVE

Our review aims to study the depth of various variants of ILD, diagnostic procedures, pathophysiology, molecular dysfunction and regulation, subject and objective assessment techniques, pharmacological intervention, exercise training and various modes of delivery for rehabilitation.

METHOD

Articles are reviewed from PubMed and Scopus and search engines.

RESULTS

ILD is a rapidly progressing disease with a high mortality rate. Each variant has its own set of causal agents and expression patterns. Patients often find it challenging to self-manage due to persistent symptoms and a rapid rate of worsening. The present review elaborated on the pathophysiology, risk factors, molecular mechanisms, diagnostics, and therapeutic approaches for ILD will guide future requirements in the quest for innovative and tailored ILD therapies at the molecular and cellular levels.

CONCLUSION

The review highlights the rationale for conventional and novel therapeutic approaches for better management of ILD.

Mechanistic and Therapeutic Approaches to Occupational Exposure-Associated Allergic and Non-Allergic Asthmatic Disease

PURPOSE OF REVIEW

Occupational lung disease, including asthma, is a significant cause of disability worldwide. The dose, exposure frequency, and nature of the causal agent influence the inflammatory pathomechanisms that inform asthma disease phenotype and progression. While surveillance, systems engineering, and exposure mitigation strategies are essential preventative considerations, no targeted medical therapies are currently available to ameliorate lung injury post-exposure and prevent chronic airway disease development.

RECENT FINDINGS

This article reviews contemporary understanding of allergic and non-allergic occupational asthma mechanisms. In addition, we discuss the available therapeutic options, patient-specific susceptibility and prevention measures, and recent scientific advances in post-exposure treatment conception. The course of occupational lung disease that follows exposure is informed by individual predisposition, immunobiologic response, agent identity, overall environmental risk, and preventative workplace practices. When protective strategies fail, knowledge of underlying disease mechanisms is necessary to inform targeted therapy development to lessen occupational asthma disease severity and occurrence.

Caveolin-1 and Its Functional Peptide CSP7 Affect Silica-Induced Pulmonary Fibrosis by Regulating Fibroblast Glutaminolysis

Exposure to silica is a cause of pulmonary fibrosis disease termed silicosis, which leads to respiratory failure and ultimately death. However, what drives fibrosis is not fully elucidated and therapeutic options remain limited. Our previous RNA-sequencing analysis showed that the expression of caveolin-1 (CAV1) was downregulated in silica-inhaled mouse lung tissues. Here, we not only verified that CAV1 was decreased in silica-induced fibrotic mouse lung tissues in both messenger RNA and protein levels, but also found that CSP7, a functional peptide of CAV1, could attenuate pulmonary fibrosis in vivo. Further in vitro experiments revealed that CAV1 reduced the expression of Yes-associated protein 1(YAP1) and affected its nuclear translocation in fibroblasts. In addition, Glutaminase 1 (GLS1), a key regulator of glutaminolysis, was identified to be a downstream effector of YAP1. CAV1 could suppress the activity of YAP1 to decrease the transcription of GLS1, thereby inhibiting fibroblast activation. Taken together, our results demonstrated that CAV1 and its functional peptide CSP7 may be potential molecules or drugs for the prevention and intervention of silicosis.

Differential immunological effects of silica nanoparticles on peripheral blood mononuclear cells of silicosis patients and controls

Silicosis is a fibrotic disease caused by the inhalation of respirable silica particles, which are typically engulfed by alveolar macrophages and subsequently induce the release of inflammatory cytokines. Various animal experimental and human studies have focused on modeling silicosis, to assess the interactions of macrophages and other cell types with silica particles. There is still, however, limited knowledge on the differential response upon silica-exposure between silicosis patients and controls. We focused on studying the responsiveness of peripheral blood mononuclear cells (PBMCs) to silica nanoparticles (SiNPs) - Ludox and NM-200 - of silicosis patients and controls. The proliferative capacity of T- CD3⁺ and B- CD19⁺ cells, were evaluated via Carboxyfluorescein succinimidyl ester (CFSE) assay. The activation status of lymphocyte subsets and response to silica were also evaluated by comparing the extent of micro-granuloma or aggregate formation with the cytokine secretion profiles between both groups of individuals. The proliferative capacity of CD19⁺ cells was elevated in silicotic patients as opposed to controls. Subsets of regulatory T cells (CD4⁺ CD25⁺ and CD8⁺ CD25⁺) and immunoglobulins IgM and IgG were also significantly increased in patients. The number and the size of aggregates formed were higher with SiNPs stimulation in patients compared to controls. Multivariable analysis also elucidated the role of key cytokines like interleukin-1β (IL-1β), IL-6 and interferon-gamma (IFN-γ), which were upregulated in SiNP-stimulated PBMCs of patients compared to controls. Our ex vivo model thus has potential to provide insights into the immunological effects of silica particles in lymphocytes of silicosis patients and controls.

Occupational Exposure to Dust and the Relationship with the Respiratory Symptoms, Lung Function among Construction Workers of the University of Malaysia Sabah

BACKGROUND: The respiratory tract often becomes the site of injury from occupational exposure. All construction sites generate high levels of dust, typically from concrete, silica, asbestos, cement, wood, and stone, sand, and therefore, the workers are exposed to this airborne dust and increased their risk of developing respiratory disorders. Limited studies have been conducted to assess the relationship between respiratory symptoms, lung function, and occupational dust exposure among construction workers in Sabah. AIM: The objectives of this study are to determine the occupational exposure to dust and the relationship with the respiratory symptoms as well as lung function among construction workers in UMS Teaching Hospital. MATERIALS AND METHODS: This cross-sectional study consisted of construction workers working in all sections in the development of UMS Teaching Hospital. A standard respiratory questionnaire was distributed to construction workers and lung function measurement was performed using Spirometry and the results of their respiratory status were compared between workers who were exposed and unexposed to dust. Occupational dust exposure was determined by the gravimetric method using an air sampler. The total duration of the collection was 8 h and the filters with the dust samples were analyzed in the laboratory. RESULTS: The result showed three parameters that were significantly associated with respiratory symptoms, namely, age, marital status, and smoking status. Male workers had a higher prevalence (42.7%) of having respiratory symptoms compared to female workers (21.4%). Widow/widower/divorced (50.0%) had a higher prevalence of having respiratory symptoms compared to married (45.8%) or single workers (25.0%). Workers who smoke had a higher prevalence (51.2%) of having respiratory symptoms compared to non-smoker’s workers (22.7%). CONCLUSION: The highest dust exposure is the piping workstation, followed by the cement and plastering workstations. These warrant the compulsory use of personal protective equipment by construction workers during work, improving the quality of dust masks, and standardizing their usage. Effective engineering controls should also be promoted on construction sites.

Presumed Exposure to Chemical Pollutants and Experienced Health Impacts among Warehouse Workers at Logistics Companies: A Cross-Sectional Survey

During intercontinental shipping, freight containers and other closed transport devices are applied. These closed spaces can be polluted with various harmful chemicals that may accumulate in poorly ventilated environments. The major pollutants are residues of pesticides used for fumigation as well as volatile organic compounds (VOCs) released from the goods. While handling cargos at logistics companies, workers can be exposed to these pollutants, frequently without adequate occupational health and safety precautions. A cross-sectional questionnaire survey was conducted among potentially exposed warehouse workers and office workers as controls at Hungarian logistics companies (1) to investigate the health effects of chemical pollutants occurring in closed spaces of transportation and storage and (2) to collect information about the knowledge of and attitude toward workplace chemical exposures as well as the occupational health and safety precautions applied. Pre-existing medical conditions did not show any significant difference between the working groups. Numbness or heaviness in the arms and legs (AOR = 3.99; 95% CI = 1.72–9.26) and dry cough (AOR = 2.32; 95% CI = 1.09–4.93) were significantly associated with working in closed environments of transportation and storage, while forgetfulness (AOR = 0.40; 95% CI = 0.18–0.87), sleep disturbances (AOR = 0.36; 95% CI = 0.17–0.78), and tiredness after waking up (AOR = 0.40; 95% CI = 0.20–0.79) were significantly associated with employment in office. Warehouse workers who completed specific workplace health and safety training had more detailed knowledge related to this workplace chemical issue (AOR = 8.18; 95% CI = 3.47–19.27), and they were significantly more likely to use certain preventive measures. Warehouse workers involved in handling cargos at logistics companies may be exposed to different chemical pollutants, and the related health risks remain unknown if the presence of these chemicals is not recognized. Applied occupational health and safety measures at logistics companies are not adequate enough to manage this chemical safety issue, which warrants awareness raising and the introduction of effective preventive strategies to protect workers’ health at logistics companies.