pulmonary disorders
Overview of Environmental and Occupational Pulmonary Diseases
Prevention
Prevention of environmental and occupational pulmonary diseases centers on reducing or eliminating exposure (primary prevention). Exposure can be reduced or eliminated using the hierarchy of controls, in the order of most to least effective: Elimination (eg, removing the hazard from the workplace) Product substitution (eg, using safer, less toxic materials) Engineering controls (eg, enclosures, ventilation systems, safe clean-up procedures) Administrative controls (eg, limiting the number of people exposed to hazardous conditions) Personal protective equipment (eg, respirator, dust mask) Although respirators reduce exposure, they are the least preferred type of control. They should be considered when more effective interventions are not feasible or do not sufficiently reduce the hazard. Respiratory protection typically is worn for high-risk specific tasks and not for an entire workday. When a respirator is required to protect the employee's health, the employee should be enrolled in their employer-mandated written respiratory protection program, which includes medical evaluation and annual respiratory fit testing to ensure proper fit. Medical evaluation includes assessment of whether the patient is able to tolerate the type of respirator that will be used in the workplace given their health status. Medical surveillance is a form of secondary prevention. In medical surveillance, scheduled evaluations, such as spirometry or chest imaging, are conducted to identify disorders early when exposure reduction and other interventions might help reduce long-term consequences. The United States Occupational Safety and Health Administration (OSHA) mandates medical surveillance for select exposures such as asbestos and silica. 