Preventive measures and management
Prevention is the best tool for avoiding work-related lung diseases. The main goal must be to reduce or avoid any hazardous exposure.
In the first place, exposure levels should be controlled by practicable measures, such as substitution of hazardous substances, automation or enclosure of industrial processes, and improvement of work area ventilation; things we mentioned before in the session about risk assessment. In mining, for instance, wet drilling, effective design and maintenance of ventilation systems, watering down, dust suppression and capturing systems, adequate re-entry arrangements and, as a last resort, correct use of respirators, are examples of good practice.
Respiratory protective equipment
Respiratory protective equipment should be used as a last resort - when an inhalation exposure risk remains after other reasonable controls have been put in place. It may also be used as additional, back-up protection should the other control measures fail to operate.
The use of respiratory protective equipment is not a safe way to avoid exposure completely, but, correctly used, it will reduce the exposure. A respirator that is not correctly used, however, or a mask that is not suited to the task, can, on the contrary, result in high exposure due to a false sense of protection. Careful risk assessment of the work place is therefore of utmost importance to decide what kind of respiratory protective equipment should be used for optimal protection.
Types of respiratory protective equipment range from relatively inexpensive single-use, disposable masks to more robust reusable models with replaceable cartridges.
There are two principal types of respiratory protective equipment:
- Respirators that use filters to remove the contaminants. Different filters are used according to the specific contaminant such as dust and different kinds of gases. Some respirators have combinations of different filters.
- Breathing apparatus that supplies air from a clean source (e.g. air compressor or air cylinder)
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This kind of respirator is designed to filter out dust only. It must not be used where there is an oxygen-deficient atmosphere or where harmful gases and vapours are present.
© G. Tjalvin
Dependent on the replaceable cartridges, this kind of respirator is designed to remove gases, volatile organic compounds, and other vapors from the inhaled air. A typical organic vapor respirator cartridge is a metal or plastic case containing activated charcoal or certain resins. The filter cartridges must be changed when they become saturated or particulate accumulation within them begins to restrict airflow.
© G. Tjalvin
Management of obstructive lung diseases
Management of work-related asthma
It is generally accepted that workers who have occupational asthma should avoid persistent exposure to the causal agent in order to prevent any aggravation of the asthma symptoms. In the case of immunological asthma, even a very low exposure to the causal agent can result in a massive asthma attack. A shorter symptomatic period after diagnosis is associated with a better outcome, as long as the causal agent is avoided. Otherwise the asthma can turn out to be chronic.
In contrast, for work-aggravated asthma, a substantial reduction of the exposure might lead to improvement or even resolution of the asthma symptoms.
Management of chronic obstructive pulmonary disease (COPD)
Workers who have COPD may be able to continue to work in their usual jobs if their exposure to vapors, gas, dust and fumes is reduced, for instance by substitution of other materials or chemicals for the hazardous one, or by undertaking changes to the physical set-up, such as enclosing the industrial process and improving work area ventilation. Respiratory protective equipment (RPE) should be used as a last resort, and used only when inhalation exposure risk remains after other reasonable controls have been put in place. Persistent exposure to high levels of dust should be avoided.
© University of Bergen/Author: G. Tjalvin.