Occupational and Environmental Disease Service

What are occupational and environmental lung diseases?

Occupational and environmental lung diseases are caused by the inhalation of chemical irritants, allergens or toxins in work or home environments. Most diseases are caused by repeated, long-term exposure, but even a one-time or indirect contact with a hazardous agent can result in lung diseases with lasting effects.

The introduction of regulatory agencies and enforcement of dust regulations has greatly decreased the prevalence of these diseases, but many people continue to suffer from lung diseases due to environmental factors. In most cases, these diseases result from inorganic dust exposure during manufacturing, processing or mining (pneumoconiosis). Other common occupational lung diseases include:

• Asbestosis
• Occupational asthma
• Byssinosis
• Coal worker’s pneumoconiosis (black lung disease)
• Chronic obstructive pulmonary disease (COPD)
• Hypersensitivity pneumonitis
• Interstitial lung disease (ILD)
• Mesothelioma
• Silicosis

Pulmonologists and thoracic surgeons who specialize in occupational and environmental lung health at Mass General Brigham provide comprehensive care for patients with occupational and environmental lung diseases. Their expertise and collaboration with other specialists throughout Mass General Brigham provide patients with a highly informed diagnosis and a cohesive treatment plan.

Factors contributing to an increased risk for occupational and environmental lung diseases include:

• Occupational exposure to unsafe chemicals, dusts and fibers
• Smoking or frequent exposure to secondhand smoke

Occupational and environmental lung diseases can be caused or exacerbated by exposure to:

• Arsenic
• Asbestos
• BCME (Bis(chloromethyl) ether)
• Beryllium
• Cadmium
• Chromium
• Coal dust
• Diesel exhaust
• Flock
• Nanoparticles
• Nickel
• Polycyclic aromatic hydrocarbons
• Silica
• Tobacco smoke

The most common symptoms of occupational and environmental lung diseases are:

• Chest pain
• Chest tightness
• Cough
• Irregular breathing patterns
• Shortness of breath that gets worse with activity (dyspnea)

Your physician will review your medical history and perform a physical exam to determine the cause of your occupational or environmental lung disease. He or she may also order additional tests, including:

• Biochemical and cellular studies of lung fluids, tissues and cells
• Blood tests
• Bronchoscopy
• Chest X-ray
• Computerized tomography (CT) scan
• Pulmonary function tests

While there is no cure for the majority of occupational and environmental lung diseases, our specialists will work with you to manage your symptoms and prevent further exposure.

Your physician may recommend that you:

• Quit smoking
• Wear protective masks when around airborne dusts and irritants
• Evaluate lung function with spirometry according to your physician’s instructions to familiarize yourself with your lung function and watch for changes
• Eat a well-balanced diet, exercise regularly and get plenty of sleep
• Hire an occupational health expert to investigate your work environment
• Oxygen therapy when needed

Depending on your lung disease, your doctor may prescribe antihistamines to treat allergies or bronchodilators to open lung passages. A lung transplant may be required in more serious cases.

A multidisciplinary team will work with you every step of the way, from diagnostics through evaluation, to create a cohesive and comprehensive treatment plan. Our unique approach features same day consultations with multiple specialists and fosters seamless, expert care. Your medical condition will be closely monitored and managed to promote optimal lung functioning and an improved quality of life.

If you require surgery, you will meet with your health care team first for pre-operative information and tests. On the day of your surgery, you will receive care from surgeons, anesthesiologists and nurses who specialize in thoracic surgery and interventional pulmonary procedures. After surgery, you will recover in our designated thoracic post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Occupational and environmental lung disease patients benefit from the wide range of specialists at Mass General Brigham, including thoracic surgeons, oncologists, pulmonologists and imaging experts. This collaboration ensures comprehensive diagnosis and targeted treatment for patients.

Any recommended surgery or procedure will be performed by an experienced, board-certified surgeon, in collaboration with the treatment team including nurses and physician assistants, all of whom specialize in taking care of patients with occupational and environmental lung diseases.