Publications
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.
Assessment of cancer biomarkers in the Grenfell firefighter cohort study
Scoping review of exposure questionnaires and surveys in interstitial lung disease
Background Many interstitial lung diseases (ILDs) have clear causal relationships with environmental and occupational exposures. Exposure identification can assist with diagnosis, understanding disease pathogenesis, prognostication and prevention of disease progression and occurrence in others at risk. Despite the importance of exposure identification in ILD, there is no standardised assessment approach. Many questionnaires are in clinical and research use, yet their utility, applicability, relevance and performance characteristics are unknown.
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
Small airways obstruction and mortality: findings from the UK Biobank
Background
Small airways obstruction (SAO) is common in general populations. It has been associated with respiratory symptoms, cardiometabolic diseases, and progression to COPD over time. Whether SAO predicts mortality is largely unknown.
Research Question
Is spirometry-defined SAO associated with increased mortality?
Methods
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.
Relationship between cumulative silica exposure and silicosis: a systematic review and dose-response meta-analysis
Artificial stone silicosis: A UK case series
Silicosis due to artificial stone (AS) has emerged over the last decade as an increasing global issue. We report the first eight UK cases. All were men; median age was 34 years (range 27–56) and median stone dust exposure was 12.5 years (range 4–40) but in 4 cases was 4–8 years. One is deceased; two were referred for lung transplant assessment. All cases were dry cutting and polishing AS worktops with inadequate safety measures. Clinical features of silicosis can closely mimic sarcoidosis.
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: when should I think of it and why is it important?
Exposure to toxic inhalants in the workplace has the potential to cause (in susceptible individuals) almost any major type of lung disease, such as asthma, COPD and interstitial lung diseases. Patients with occupational lung disease will often present to or will be managed by respiratory specialists without training in occupational respiratory medicine, and patients (or their clinicians) may not identify a link between their disease and their current or a past job.
