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Physiology and Biomarkers for Surveillance of Occupational Lung Disease
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1766119Respiratory surveillance is the process whereby a group of exposed workers are regularly tested (or screened) for those lung diseases which occur as a result of a specific work exposure. Surveillance is performed by assessing various measures of biological or pathological processes (or biomarkers) for change over time. These traditionally include questionnaires, lung physiological assessments (especially spirometry), and imaging. Early detection of pathological processes or disease can enable removal of a worker from a potentially harmful exposure at an early stage. In ...
Source: Seminars in Respiratory and Critical Care Medicine - April 18, 2023 Category: Respiratory Medicine Authors: Yates, Deborah H. Tags: Review Article Source Type: research

Artificial Intelligence in Quantitative Chest Imaging Analysis for Occupational Lung Disease
We describe the long journey in the pursuit of CAD of pneumoconioses including our recent proposal of a new expert system. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Respiratory and Critical Care Medicine)
Source: Seminars in Respiratory and Critical Care Medicine - April 18, 2023 Category: Respiratory Medicine Authors: Suganuma, Narufumi Yoshida, Shinichi Takeuchi, Yuma Nomura, Yoshua K. Suzuki, Kazuhiro Tags: Review Article Source Type: research

Work-Related Sleep Disorders: Causes and Impacts
This article describes the clinical manifestations and impact of these sleep disorders, particularly as they pertain to workers' health and those with safety-sensitive positions. Sleep deprivation, circadian rhythm disruptions, and excessive daytime sleepiness—hallmarks of insufficient sleep, shift work disorder, and OSA, respectively—all lead to a series of cognitive deficits and impaired concentration that affect workers in a wide variety of fields. We describe the health consequences of these disorders along with treatment strategies, with a focus on current regulatory standards and the under-recognition of OSA in c...
Source: Seminars in Respiratory and Critical Care Medicine - April 18, 2023 Category: Respiratory Medicine Authors: Gusman, Elen Standlee, Jordan Reid, Kathryn J. Wolfe, Lisa F. Tags: Review Article Source Type: research

Global Trends in Occupational Lung Disease
This study reviews recent estimates of the burden of the most important occupational lung diseases using data published by United Nations specialized agencies as well as the Global Burden of Disease studies. We focus on occupational chronic respiratory disease of which chronic obstructive lung disease and asthma are the most significant. Among occupational cancers, lung cancer is the most common, and is associated with more than 10 important workplace carcinogens. Classic occupational interstitial lung diseases such as asbestosis, silicosis, and coal workers' pneumoconiosis still comprise a substantial burden of disease in...
Source: Seminars in Respiratory and Critical Care Medicine - April 18, 2023 Category: Respiratory Medicine Authors: Cohen, Robert A. Go, Leonard H.T. Rose, Cecile S. Tags: Review Article Source Type: research

Deployment-Related Respiratory Disease: Where Are We?
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1764407Military personnel and veterans who have deployed to Afghanistan, Iraq, and parts of Southwest Asia (SWA) since 1990 are at risk of developing a host of respiratory symptoms and deployment-related respiratory diseases (DRRDs). This review aims to summarize our current understanding of DRRD and inform pulmonary practitioners of recent updates to DRRD screening, diagnosis, evaluation, and management. The most common respiratory diseases in these patients include asthma, chronic sinonasal disease, laryngeal disease/dysfunction, and distal lung disease. Pulmonary function t...
Source: Seminars in Respiratory and Critical Care Medicine - April 17, 2023 Category: Respiratory Medicine Authors: Krefft, Silpa D. Zell-Baran, Lauren M. Tags: Review Article Source Type: research

Chronic Obstructive Pulmonary Disease and Work: The Continuing Narrative
This article, intended for the clinician, summarizes some of this evidence and some areas of controversy. Current estimates based on pooled epidemiological analyses of population-based studies identify that approximately 14% of the burden of COPD (and 13% of the burden of chronic bronchitis) is attributable to such exposures. In addition to these approaches, various studies implicate specific exposures as contributing. Certain of these relating to cadmium, coal, and respirable crystalline silica are discussed in more detail. Despite this amassed evidence to date supporting associations between COPD and workplace exposures,...
Source: Seminars in Respiratory and Critical Care Medicine - April 17, 2023 Category: Respiratory Medicine Authors: Fishwick, David Barber, Chris Wiggans, Ruth Tags: Review Article Source Type: research

Importance of and Approach to Taking a History of Exposures to Occupational Respiratory Hazards
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1766120Occupational respiratory diseases are caused by exposure to respiratory hazards at work. It is important to document those exposures and whether they are causing or exacerbating disease because these determinations can have important impacts on diagnosis, treatment, job restrictions, and eligibility for benefits. Without investigation, it is easy to miss clinically relevant exposures, especially in those with chronic diseases that can have work and nonwork causes. The first and most important step in identifying exposures to respiratory hazards at work is to take an app...
Source: Seminars in Respiratory and Critical Care Medicine - April 4, 2023 Category: Respiratory Medicine Authors: Weissman, David N. Radonovich, Lewis J. Tags: Review Article Source Type: research

The Emerging Spectrum of Respiratory Diseases in the U.S. Cannabis Industry
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1766116While the cannabis industry is one of the fastest growing job markets in the United States and globally, relatively little is known about the occupational hazards that cannabis production workers face. Based on the closely related hemp industry and preliminary studies from recreational cannabis grow facilities, there is concern for significant respiratory exposures to bioaerosols containing microbial and plant allergens, chemicals such as pesticides, volatile organic compounds, and other irritant gases. Components of the cannabis plant have also recently been identified...
Source: Seminars in Respiratory and Critical Care Medicine - April 4, 2023 Category: Respiratory Medicine Authors: Sack, Coralynn Simpson, Christopher Pacheco, Karin Tags: Review Article Source Type: research

Transmission and Risk Factors of COVID-19 among Health Care Workers
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1766118Coronavirus disease 2019 (COVID-19) poses a significant occupational risk factor to health care workers (HCWs). As in previous events, this occupational risk amplifies and compounds the adverse impact of the pandemic. We conducted a narrative review summarizing risk factors associated with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) transmission in HCWs. We searched for original observational studies (including case-control, cross-sectional, prospective and retrospective cohorts) using PubMed, Scopus, and Google Scholar. A total of 22 articles were revi...
Source: Seminars in Respiratory and Critical Care Medicine - April 4, 2023 Category: Respiratory Medicine Authors: Alghader, Majdi R.M. Valvi, Damaskini de la Hoz, Rafael E. Tags: Review Article Source Type: research

Pathology and Mineralogy of the Pneumoconioses
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1764406Pneumoconioses represent the spectrum of lung diseases caused by inhalation of respirable particulate matter small enough (typically <5-µm diameter) to reach the terminal airways and alveoli. Pneumoconioses primarily occur in occupational settings where workers perform demanding and skilled manual labor including mining, construction, stone fabrication, farming, plumbing, electronics manufacturing, shipyards, and more. Most pneumoconioses develop after decades of exposure, though shorter latencies can occur from more intense particulate matter exposures. In this rev...
Source: Seminars in Respiratory and Critical Care Medicine - March 27, 2023 Category: Respiratory Medicine Authors: Hua, Jeremy T. Cool, Carlyne D. Green, Francis H. Y. Tags: Review Article Source Type: research

Advanced Cystic Fibrosis Lung Disease and Lung Transplantation in the Era of Cystic Fibrosis Transmembrane Conductance Regulator Modulators
This article describes the impact of highly effective modulator therapy (HEMT) on the natural history of CF and the influence on the timing of referral and consideration of listing for lung transplantation. CF clinicians play a pivotal role to ensure that the impetus of the CF foundation consensus guidelines to facilitate timely referral for lung transplantation is not lost among the excitement of anticipated sustained benefit from HEMT. While the widespread availability of elexacaftor/tezacaftor/ivacaftor over the past 2 years has been associated with a sharp drop in the number of people referred for consideration for lun...
Source: Seminars in Respiratory and Critical Care Medicine - March 9, 2023 Category: Respiratory Medicine Authors: O'Carroll, Mark Tags: Review Article Source Type: research

Clinical Relevance of Fungi in Cystic Fibrosis
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1759882In cystic fibrosis, a new era has started with the approval and use of highly effective cystic fibrosis transport regulator (CFTR) modulator therapy. As pulmonary function is increasing and exacerbation rate significantly decreases, the current meaning of fungal pulmonary diseases is questioned. During the past couple of decades, several studies have been conducted regarding fungal colonization and infection of the airways in people with cystic fibrosis. Although Aspergillus fumigatus for filamentous fungi and Candida albicans for yeasts remain by far the most common fu...
Source: Seminars in Respiratory and Critical Care Medicine - February 6, 2023 Category: Respiratory Medicine Authors: Schwarz, Carsten Tags: Review Article Source Type: research

Diagnosis and Management of Cystic Fibrosis Exacerbations
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1760250With the improving survival of cystic fibrosis (CF) patients and the advent of highly effective cystic fibrosis transmembrane conductance regulator (CFTR) therapy, the clinical spectrum of this complex multisystem disease continues to evolve. One of the most important clinical events for patients with CF in the course of this disease is acute pulmonary exacerbation (PEx). Clinical and microbial epidemiology studies of CF PEx continue to provide important insight into the disease course, prognosis, and complications. This work has now led to several large-scale clinical ...
Source: Seminars in Respiratory and Critical Care Medicine - February 6, 2023 Category: Respiratory Medicine Authors: Milinic, Tijana McElvaney, Oliver J. Goss, Christopher H. Tags: Review Article Source Type: research

Cystic Fibrosis
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1760754 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Respiratory and Critical Care Medicine)
Source: Seminars in Respiratory and Critical Care Medicine - January 24, 2023 Category: Respiratory Medicine Authors: Mulrennan, Siobhain Jones, Andrew M. Tags: Preface Source Type: research

Nontuberculous Mycobacteria in Cystic Fibrosis in the Era of Cystic Fibrosis Transmembrane Regulator Modulators
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1759883Nontuberculous mycobacteria (NTM) are a group of mycobacteria which represent opportunistic pathogens that are of increasing concern in people with cystic fibrosis (pwCF). The acquisition has been traditionally though to be from environmental sources, though recent work has suggested clustered clonal infections do occur and transmission potential demonstrated among pwCF attending CF specialist centers. Guidelines for the screening, diagnosis, and identification of NTM and management of pwCF have been published. The emergence of CF-specific therapies, in particular cysti...
Source: Seminars in Respiratory and Critical Care Medicine - January 17, 2023 Category: Respiratory Medicine Authors: Burke, Andrew Thomson, Rachel M. Wainwright, Claire E. Bell, Scott C. Tags: Review Article Source Type: research