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When work takes your breath away


When it comes to safety in the workplace one is inclined to think primarily of accidents that can occur while using machinery and tools, while driving motor vehicles, through accidental contact with irritants/corrosive substances or otherwise capable of causing immediate and obvious damage to the body, or from injuries and falls.

The attention devoted to the air quality breathed in factories, construction sites, or areas characterized by high air pollution, chemical pollution, or burning of hydrocarbons or other materials, on the other hand, tends to be very low, despite the fact that the detrimental effects on the respiratory system of many gases, fumes, and more or less fine dust are well known.

Emphasizing the importance of increasing precautions and protective measures from air toxics for people employed in risky work settings are the two leading international scientific societies concerned with respiratory medicine: the European Respiratory Society (ERS) and the American Thoracic Society (ATS).

Conducting an extensive review of the major studies on the subject published in the literature, ERS/ATS experts found that those who work (and breathe) in high-risk locations have a markedly elevated likelihood of developing numerous chronic respiratory diseases, which are characterized by a high impact on health, productivity and the health care expenditures that countries must incur to provide appropriate treatment and care.

Even without considering neoplasms of the respiratory system (which were not the subject of the research), the societal and health repercussions appear enormous, including in terms of associated disability and mortality.

In particular, respiratory diseases most frequent chronic diseases promoted by occupational exposure are sarcoidosis and other granulomatous diseases (30%); alveolar proteinosis (29%); idiopathic pulmonary fibrosis (26%); hypersensitivity pneumonitis (19%); asthma (16%); chronic obstructive pulmonary disease-CPD (14%); chronic bronchitis (13%); community-acquired pneumonia of working age (10%); and tuberculosis (2.3% in workers exposed to silica; 1% among those working in health care).

In many cases, these are pathologies that cause non-reversible, progressively evolving and tend to be disabling damage/ dysfunctions, as well as often lacking adequate therapeutic solutions and such that not only the quality of life is substantially reduced, but also its duration.

In the face of these outcomes, ERS/ATS experts recommend the timely adoption of appropriate measures to reduce the production of hazardous volatile compounds in workplaces and the introduction of effective protective measures that can protect the respiratory system as much as possible of all those who necessarily have to perform their professional activities in hazardous environments. Will they be heard?

As we await a legislative response from governments and a positive response from employers, it pays to be aware of the health hazards that can be incurred in relation to the type and location of work being done and to not neglect any of the safety measures already in place, firmly calling for their improvement where they are insufficient. In addition, it is crucial to pay attention to any respiratory disorder that tends to persist beyond 7-14 days or recur frequently and submit it for medical evaluation, specifying its occupational context.

Source Blanc PD et al. The Occupational Burden of Nonmalignant Respiratory Diseases An Official American Thoracic Society and European Respiratory Society Statement. Am J Respir Crit Care Med 2019;199(11):1312-1334. doi:10.1164/rccm.201904-0717ST (


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