Prevalence and Risk Factors for Pulmonary Conditions among Farmers and Ranchers in the Central United States

Acute occupational inhalation injuries-United States, 2011-2022

BACKGROUND

Inhalation injuries due to acute occupational exposures to chemicals are preventable. National surveillance of acute inhalation exposures is limited. This study identified the most common acute inhalation exposure-related incidents by industry sector among US workers.

METHODS

To characterize inhalation-related injuries and their exposures during April 2011-March 2022, state and federal records from the Occupational Safety and Health Administration (OSHA) Occupational Safety and Health Information System (OIS) accident database were analyzed. Industry-specific injury, hospitalization, and fatality rates were calculated.

RESULTS

The most frequent acute inhalation incidents investigated by OSHA were caused by inorganic gases (52.9%) such as carbon monoxide (CO) or acids, bases, and oxidizing chemical agents (12.9%) such as anhydrous ammonia. The largest number of fatal and nonfatal injuries were reported in the manufacturing (28.6%) and construction (17.2%) sectors.

CONCLUSIONS

Workers were affected by acute inhalation exposures in most industries. Using this surveillance, employers can recognize frequently-occurring preventable acute inhalation exposures by industry, such as inorganic gases in the manufacturing sector, and implement prevention measures. Training of workers on exposure characteristics and limits, adverse health effects, and use of protective equipment by exposure agent can prevent inhalation injuries.

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.

Fungal bioaerosols as an occupational hazard

PURPOSE OF REVIEW

Over the past 40 years, the circumstances where fungal bioaerosols are major issues have shifted because of changes in the industrial sector from mainly agriculture to operations, including composting, cannabis production and forestry in hot humid conditions. Changes in the design and operation of nonindustrial workplaces meant that mould and dampness became major issues that are just being reduced. This review attempts to frame that history offers a perspective on the current thinking on mechanisms and provide potentially useful sources of information for physicians and their patients.

RECENT FINDINGS

The major impact of fungal exposures is not only from their allergens but also from an array of Danger-Associated Molecular Pattern molecules, possibly the most important of which is the type of glucan found in moulds that grow in damp buildings, wood chips and crops, that is beta 1, 3 D glucan in triple helical form. Located in lung epithelia, the dectin receptor is exquisitely sensitive to this compound. Except in some agricultural workplaces, low molecular weight secondary metabolites often mischaracterized as mycotoxins play little, if any, role on population health.

SUMMARY

There has been a convergence in thinking between the allergy and industrial hygiene communities as well as government agencies on mould and occupational health. This has led to some useful strategies for better managing these issues as well as increasing consumer awareness.