Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
Eur Respir Rev. 2017 Nov 15;26(146). doi: 10.1183/16000617.0080-2017. Print 2017 Dec 31.
Occupational lung diseases are an important public health issue and are avoidable through preventive interventions in the workplace. Up-to-date knowledge about changes in exposure to occupational hazards as a result of technological and industrial developments is essential to the design and implementation of efficient and effective workplace preventive measures. New occupational agents with unknown respiratory health effects are constantly introduced to the market and require periodic health surveillance among exposed workers to detect early signs of adverse respiratory effects. In addition, the ageing workforce, many of whom have pre-existing respiratory conditions, poses new challenges in terms of the diagnosis and management of occupational lung diseases. Primary preventive interventions aimed to reduce exposure levels in the workplace remain pivotal for elimination of the occupational lung disease burden. To achieve this goal there is still a clear need for setting standard occupational exposure limits based on transparent evidence-based methodology, in particular for carcinogens and sensitising agents that expose large working populations to risk. The present overview, focused on the occupational lung disease burden in Europe, proposes directions for all parties involved in the prevention of occupational lung disease, from researchers and occupational and respiratory health professionals to workers and employers.
职业性肺部疾病是一个重要的公共卫生问题,可以通过在工作场所采取预防措施来避免。了解由于技术和工业发展而导致的职业危害暴露的最新变化,对于设计和实施高效、有效的工作场所预防措施至关重要。新的职业性接触物具有未知的呼吸健康影响,不断被引入市场,需要对接触工人进行定期健康监测,以发现不良呼吸影响的早期迹象。此外,老龄化的劳动力队伍中,许多人都有预先存在的呼吸状况,这给职业性肺部疾病的诊断和管理带来了新的挑战。旨在降低工作场所暴露水平的初级预防干预措施仍然是消除职业性肺部疾病负担的关键。为了实现这一目标,仍然需要根据透明的循证方法制定标准职业接触限值,特别是对于使大量工人面临风险的致癌物质和致敏物质。本综述重点关注欧洲的职业性肺部疾病负担,为预防职业性肺部疾病的所有相关方(从研究人员、职业和呼吸健康专业人员到工人和雇主)提出了方向。