Patients’ jobs are vital to consider when assessing respiratory health, say experts, after new research warns against vapours, gases, dusts, fumes and solvents.
Any exposure to gases, dusts, fumes or solvents in the workplace is a major risk factor for worsening lung health, according to a new systematic review.
Melbourne epidemiologist and lead author Dr Sheikh Alif said it was crucial that GPs consider the workplace as a risk factor when treating susceptible patients.
“The gradual decline of forced expiratory volume and forced vital capacity may worsen existing lung diseases, and untreated patients may develop obstructive airway disease in their later life,” the research fellow at Monash University told The Medical Republic.
Previous research indicated that certain occupational exposures resulted in a more rapid decline in FEV1 and forced vital capacity. However, these were typically cross-sectional studies and failed to include many workplace exposures.
So the Victorian researchers analysed 12 longitudinal population-based studies of workplace exposures and forced expiratory volume (FEV1).
The analysis of around 70,000 participants, tracked between four and 25 years, found that lung function declines occurred after both any exposure and cumulative exposure to gases/fumes, VGDF and aromatic solvents, but not with exposure to mineral dust, herbicides and metals.
A further meta-analysis found that cumulative exposure to these workplace hazards led to persistent lung function decline.
“Lung function decline is a normal feature of ageing in adults, but excessive decline can result in lung function deficits imposing substantial public health burden,” the authors wrote.
“Periodic workplace health surveillance and lung function testing in exposed occupations will help to identify respiratory disease at an early stage to control the exposure and to protect against further disease progression,” they said.
Dr Alif suggested that GPs ask patients more questions related to their occupation, as well as the environments in which they live or work, in order to identify potential workplace risk factors that clinicians might not consider.
BMJ Occupational & Environmental Medicine 2022, online 25 October
