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Practice ABC of Occupational and Environmental Medicine, 3rd Edition

Respiratory Disorders

BMJ 2014; 348 doi: (Published 28 February 2014) Cite this as: BMJ 2014;348:bmj.g1077
  1. Ira Madan1,
  2. Paul Cullinan2
  1. 1Guy's and St Thomas' NHS Trust and King's College London, London, UK
  2. 2National Heart and Lung Institute (Imperial College) London, UK

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  • A detailed occupational history is essential for the diagnosis of occupational respiratory disorders

  • Accurate diagnosis of the subset and cause of occupational asthma is essential for optimal management of the employee

  • Globally the incidence of pneumoconiosis and byssinosis is increasing as manufacturing industries are being established and/or outsourced to developing countries, where the standard of health and safety at work may be lower than in the developed world

  • Most occupational respiratory disorders can be prevented by reducing the exposure of employees to the causative agent

The sharp reduction in the incidence of asbestosis and pneumoconioses in industrialized countries during the past 70 years is attributable to a decline in manufacturing industries and higher health and safety standards. Asthma is now the most common occupational respiratory disorder in the developed world. By contrast, the traditional occupational lung diseases are commonly seen in developing countries, and occupational asthma is reported less often. However, the true prevalence of asthma attributable to occupation in these countries remains unknown.

Since 1989, the understanding of the epidemiology of occupational lung disease in the United Kingdom has been greatly enhanced by the Surveillance of Work-related and Occupational Respiratory Disease (SWORD), which more recently has come under the umbrella of The Health and Occupation Reporting network (THOR) (Table 1). Occupational physicians, respiratory physicians and specially trained family doctors systematically report new cases of occupational lung diseases, together with the suspected agent, industry and occupation.

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Table 1

Estimated number of new UK cases of work-related and occupational respiratory diseases reported by …

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