Primary prevention of occupational lung disease: a view from the United States

Occupational lung diseases are an important source of preventable morbidity and mortality in the United States. A significant proportion of lung cancer, mesothelioma, asbestosis and the other pneumoconioses, asthma, and chronic obstructive pulmonary disease, is caused by well-established occupational agents, especially among selected subgroups of the general population. Primary prevention of this set of diseases requires identification and control of workplace hazards. In the United States, data from inspections undertaken by the Occupational Safety and Health Agency, and from periodic surveys conducted by the National Institute for Occupational Safety and Health, show that respiratory toxins are commonly found in the workplace. Workplace-based education, surveillance and exposure reduction and elimination are essential components of a strategy to prevent occupational lung disorders.