School of Biomedical Sciences and Pharmacy, The University of Newcastle/Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia.
Division of Pulmonary, Allergy, and Critical Care Medicine, Dept of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Eur Respir Rev. 2022 Jul 12;31(165). doi: 10.1183/16000617.0250-2021. Print 2022 Sep 30.
Workers in the mining and construction industries are at increased risk of respiratory and other diseases as a result of being exposed to harmful levels of airborne particulate matter (PM) for extended periods of time. While clear links have been established between PM exposure and the development of occupational lung disease, the mechanisms are still poorly understood. A greater understanding of how exposures to different levels and types of PM encountered in mining and construction workplaces affect pathophysiological processes in the airways and lungs and result in different forms of occupational lung disease is urgently required. Such information is needed to inform safe exposure limits and monitoring guidelines for different types of PM and development of biomarkers for earlier disease diagnosis. Suspended particles with a 50% cut-off aerodynamic diameter of 10 µm and 2.5 µm are considered biologically active owing to their ability to bypass the upper respiratory tract's defences and penetrate deep into the lung parenchyma, where they induce potentially irreversible damage, impair lung function and reduce the quality of life. Here we review the current understanding of occupational respiratory diseases, including coal worker pneumoconiosis and silicosis, and how PM exposure may affect pathophysiological responses in the airways and lungs. We also highlight the use of experimental models for better understanding these mechanisms of pathogenesis. We outline the urgency for revised dust control strategies, and the need for evidence-based identification of safe level exposures using clinical and experimental studies to better protect workers' health.
矿工和建筑工人由于长时间暴露在空气中含有害水平颗粒物（PM）的环境中，患呼吸道和其他疾病的风险增加。虽然已经明确了 PM 暴露与职业性肺病发展之间的联系，但这些机制仍未得到很好的理解。迫切需要更深入地了解在采矿和建筑工作场所中遇到的不同水平和类型的 PM 暴露如何影响气道和肺部的病理生理过程，并导致不同形式的职业性肺病。此类信息可用于为不同类型的 PM 制定安全暴露限值和监测指南，并开发用于早期疾病诊断的生物标志物。由于能够绕过上呼吸道的防御机制并深入穿透到肺实质中，因此具有 50%截止气流动力学直径为 10 µm 和 2.5 µm 的悬浮颗粒被认为具有生物活性，在那里它们会引起潜在的不可逆转的损伤，损害肺功能并降低生活质量。在这里，我们回顾了当前对职业性呼吸道疾病（包括煤工尘肺和矽肺）的认识，以及 PM 暴露如何影响气道和肺部的病理生理反应。我们还强调了使用实验模型来更好地理解这些发病机制的重要性。我们概述了修订粉尘控制策略的紧迫性，以及需要使用临床和实验研究来确定安全暴露水平的证据，以更好地保护工人的健康。
