Vol. 20 •Issue 22 • Page 25
For People at Risk of Lung Diseases, Basic Testing Can Be Real Boon
John worked in the same plant forever it seemed. In fact, in the small town where he grew up, the normal course of life was to graduate from high school and then get a job at the plant.
John’s problem now is that years later, he is beginning to experience some breathing problems. He is not alone.
Nicole works as a receptionist in a 50-year-old office building and is convinced her job literally makes her sick.
She reported that since she started working in the office, she has had to see her doctor on numerous occasions. Recently a lung specialist diagnosed her as an asthmatic.
People who work in certain professions where they have to handle chemicals may be well aware of the health risk associated with their jobs and the precautions necessary to avoid those risks. However, there is a growing number of people who are finding out that work may cause them harm. In the process, doctors are turning to spirometry to check for breathing problems associated with occupational hazards.
The University of Virginia Health System defines occupational lung disease as repeated and long-term exposure to certain irritants that can lead to an array of lung diseases and may have lasting effects. The disease process continues even if the irritant is removed and exposure ends.
Lung Damage Reports
Because of the nature of the work, environment or location, there are some jobs more at risk for causing occupational lung diseases than others. In fact, the American Lung Association estimates occupational lung disease is the number one cause of work-related illness. It can be caused by repeated, long-term exposure; but even a severe, single exposure to a hazardous agent can damage the lungs.
For people who smoke, occupational lung disease may increase in severity and the risk of lung cancer may go up as well.
Breathing problems associated with occupational exposure may mimic other health conditions with common symptoms like coughing, shortness of breath, chest pain and chest tightness. Those who suspect they have been exposed to irritants may certainly want to see their doctors for proper diagnosis and treatment.
Diagnosis may require an accurate and through medical history and physical, a chest X-ray and maybe even an arterial blood gas sample to measure gas exchange on the cellular level. Doctors also may want to perform a pulmonary function test (PFT) or a spirometry test.
“Spirometry is a fairly simple process that allows you to get a gauge of lung function,” said Byron Thomashow, MD, clinical professor of Medicine at Columbia University in New York and a board member of the COPD Foundation. “Spirometry gives you several bits of information like vital capacity (VC) and FEV1. These two measurements together give doctors the information they need to help them diagnose obstructive lung disease.”
Spirometry testing is quick, non-invasive and painless and measures how well the lungs exhale. The information gathered during this test is useful in diagnosing certain types of lung disorders, but is most useful when assessing for obstructive lung diseases like asthma or chronic obstructive pulmonary disease (COPD).
“COPD is the fourth leading cause of death in U.S.,” said Thomashow. “COPD often goes undiagnosed and undertreated even in people with moderate to severe disease because patients often ascribe their shortness of breath to age, weight or deconditioning and their cough and sputum to prior smoking. Spirometry is an excellent tool for making a COPD diagnosis. You cannot treat what you have not diagnosed.”
Some people believe COPD is a disease of the elderly, explained Thomashow, but through the use of spirometry, doctors have learned there are plenty of young people out there suffering with the disease.
“Spirometry should not be used routinely in all people who smoke or previously smoked as a screening test to diagnose COPD, since most smokers do not develop COPD,” explained Thomashow “However people over age 40 with appropriate exposure risks like smoking who have classic symptoms including shortness of breath, chronic cough and chronic sputum production should be tested.”
Maybe with a closer eye on occupational risks and lung health, disease symptoms can be reversed for people who need medical attention early.
Marc Willis is a Pennsylvania television reporter.