Publications
Continuous laryngoscopy during provocation in the assessment of inducible laryngeal obstruction
Transient paradoxical closure of the larynx, occurring in the absence of any underlying structural or neurological defect, is a recognized cause of paroxysmal breathlessness and wheeze. This phenomenon, most commonly termed vocal cord dysfunction and more recently termed inducible laryngeal obstruction (ILO),1 is often misdiagnosed and mistreated as asthma.2, 3 This may be explained by the lack of a robust, accepted diagnostic methodology.4, 5
Environmental and occupational exposures in interstitial lung disease
Purpose of review
We highlight recent advances in the understanding of how environmental and occupational exposures increase the risk of developing interstitial lung disease (ILD), and how to evaluate a patient for potential exposures.
Recent findings
Exacerbation patterns in adults with asthma in England. A population-based study
Rationale: Asthma is heterogeneous and knowledge on exacerbation patterns is lacking. Previous studies have had a relatively short follow-up or focused on severe disease.
Objectives: To describe exacerbation patterns over a prolonged follow-up in a population that includes patients of all disease severity.
Follow-up survey of patients with occupational asthma
Laboratory animal allergy is preventable in modern research facilities
Mortality risk associated with occupational exposures in people with small airways obstruction
Background
Small airways obstruction (SAO) has been associated with occupational exposures. Whether exposure to harmful occupational agents impacts the survival of people with SAO is unknown. Our aim was to estimate the mortality risk associated with occupational exposures among people with SAO.
Methods
Occupational contributions to Interstitial Lung Disease
- Globally, coal workers pneumoconiosis, silicosis, and asbestosis remain the most important pneumoconioses.
- Idiopathic pulmonary fibrosis (IPF) and asbestosis can be challenging to differentiate clinically, and there is clear evidence for an occupational contribution to IPF.
- Bacterial contamination of metal working fluid has recently emerged as an important cause of occupational hypersensitivity pneumonitis.
Occupational exposure to particulate matter and staff sickness absence on the London underground
The London Underground (LU) employs over 19,000 staff, some of whom are exposed to elevated concentrations of particulate matter (PM) within the network. This study quantified the occupational exposure of LU staff to subway PM and investigated the possible association with sickness absence (SA).
A job exposure matrix to quantify subway PM2.5 staff exposure was developed by undertaking measurement campaigns across the LU network. The association between exposure and SA was evaluated using zero-inflated mixed-effects negative binomial models.
Occupational exposures and small airway obstruction in the UK Biobank Cohort
Background
Small airways obstruction (SAO) is a key feature of both COPD and asthma, which have been associated with workplace exposures. Whether SAO, which may occur early in the development of obstructive lung disease and without symptoms, also associates with occupational exposures is unknown.
Methods
Occupational lung disease: what the general physician needs to know
Occupational exposures are a common and preventable cause of lung disease. About one in six cases of chronic obstructive pulmonary disease (COPD) and asthma worldwide are related to work.
