Exercise Testing in Occupational Lung Diseases

Update on respiratory disease from coal mine and silica dust

Coal mine and silica dust cause significant respiratory disease in spite of modern dust control regulations. Susceptible individuals in exposed populations may develop fibrosing lung disease, obstructive airways disease, including chronic bronchitis and emphysema, or lung cancer. A careful occupational history that elicits exposure to respiratory hazards is the cornerstone of an accurate diagnosis. Treatment involves removal from exposure, supportive care, pulmonary rehabilitation, and when disabling disease is present, assistance obtaining compensation.

Exercise testing in the assessment of pulmonary disease

In this chapter, the different types of exercise tests and the indications for requesting a particular type of test have been discussed. The normal physiological responses to exercise have been reviewed and examples of the abnormal responses seen in a variety of disease states that have been discussed. The relatively small number of these responses limits the specificity of exercise tests in actually establishing a diagnosis, but can be helpful in narrowing the differential diagnosis. Perhaps exercise tests are most valuable in cases where the patient's symptoms are mainly limited to exercise and where investigations done at rest have failed to resolve a diagnostic question. When exercise testing is used under these circumstances, it serves a unique function in the diagnosis and management of pulmonary disease.