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Lung Cancer

What are the various occupational lung diseases?

Various occupational lung diseases depend on the type of exposure. Most important are silicosis, due to exposure to silica; asbestosis, due to exposure to asbestos; asthma, which in many cases gets worse due to exposure to environmental pollutants; chronic obstructive pulmonary disease ( copd ) and other respiratory infections. Lung cancers can also be occupational and are of great concern.

Are these diseases due to the exposure to environment only or is the genetic make-up also responsible?

The primary issue is environmental exposure. But there are variations among people. It is a matter of degree. Even if you are constitutionally strong but are exposed to higher pollution levels, you are going to suffer.

Despite the awareness, why have we not been able to control them?

Incidence of certain diseases is on the rise, while others are declining. The us has been able to reduce silicosis because of stringent standards and increasing awareness levels. But incidence of other diseases, such as asthma, is on the rise because there are about 300 agents that have been confirmed through epidemiological studies and linked with asthma.

How does one know whether it is occupational or something else?

Suppose there is an adult who develops asthma later in life, then the workplace is one area that needs to be looked into. Occurrence of asthma also has some genetic component in it.

Is it true that occupational lung diseases are more hazardous for children than adults?

Certainly. It is a fact that people's lungs keep growing until the age of 25 years. If a child's lungs are exposed to certain pollutants, there is a possibility that they will never grow to their full potential. Thus their lung function goes down. I think this is an area of major concern. Exposing children and even young adults to pollutants hampers the growth of their lungs and exposes them to future infections.

Out of all these occupational lung diseases, which is the most dangerous?

This is very difficult to pinpoint. We have not even talked about whole range of lung cancers. Cancers due to occupational exposure are extremely dangerous. It also depends, among other things, on the kind and extent of exposure and the number of people getting exposed. For instance, among asthma and lung cancer, even if we have less incidence of lung cancer than asthma, we still know that in 90 per cent of the cases lung cancer is fatal.

Do occupational diseases differ in developing and developed countries?

There are differences in degree. For instance, in usa , it is now rare to find silicosis deaths. In India, there are cases where people are exposed to pollutants, develop a disease and die within five years of exposure. So here the extent of unprotected exposure is high. Also the chances of getting silicosis are high in a population that has high incidence of tuberculosis.

Does this mean that factors like socioeconomic and financial status are also responsible? Don't you think this is like getting trapped in a vicious cycle especially in developing countries India?

I would not call it vicious cycle but a complex system. There cannot be a single answer. For instance, it does not matter if you only control automobile emissions in urban areas, when one has high levels of asbestos exposure at the workplace. I think there is a need for a comprehensive multiple strategy that recognises these problems that are very resistant to simple solutions. We need to recognise factors from the personal, occupational, political and economic environment and then tackle the problem from all fronts. It is a complex problem that does not respond to simplistic solutions.

How do you think globalisation will affect occupational lung diseases?

Being in the area of public health, it is important that we have some optimism that things will move towards better. I hope that there will be exportation of knowledge, exportation of successful experiments in prevention, information that will help developing countries jump over the steps of learning and can gain experience from other countries and adapt control measures.

There are some fears as well. In many developed countries, the problems have been eliminated but the hazardous technology has been exported to the developing countries where restrictions are not very strict. But we need to have hope and concern.

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