Occupational Lung Disease: Airing on the Side of Caution; Preventive Action and a Quick Response to Complaints Can Help Employers Reduce the Estimated $8.5 Billion Price Tag of Occupational Lung Disease

Article excerpt

The air, dust and fumes some employees breathe at work are making them sick, very sick in some cases, and it's creating an ailing bottom line for employers and burdening federal programs such as Medicare.

Cases of lung cancer, obstructive lung disease (such as asthma) and chronic obstructive pulmonary diseases (such as bronchitis and emphysema), while not always work-related, are taking their toll on workers and employers.

The American Lung Association estimates that:

* More than 17,000 lung cancer deaths per year are attributable to inhalation hazards in the workplace.

* Some 6.7 million adults over the age of 18 suffered from an asthma attack during 1999, the most recent year statistics are available, and asthma -- even cases that aren't work-related -- results in 3 million lost workdays per year.

* Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the United States, claims the lives of 119,524 Americans annually.

The terms "lung disease" and "respiratory illness" cover a lot of ground. They range from the common cold to lung cancer, from asthma to allergies and from pneumoconioses to pneumonia.

J. Paul Leigh, Ph.D., a professor of health economics in the Department of Epidemiology and Preventative Medicine at the University of California-Davis School of Medicine, recently examined the direct and indirect costs of occupational lung disease. He discovered $6.6 billion was spent on obstructive lung disease in 1996, an amount that likely increased in recent years.

Leigh says if you take the increasing prevalence of COPD and asthma and add in additional costs to account for inflation, you'll find the cost in 2001 for occupational lung disease to be roughly $8.5 billion. "Clearly, this is a significant price tag that deserves attention," he notes.

What Can Employers Do?

If you are an employer or safety professional who has noticed a growing number of workers' compensation claims related to respiratory illnesses, don't take it lying down, suggests Dorsett Smith, M.D., FCCP, who has a private practice in Everett, Wash., that focuses on occupational lung disease.

First, according to Smith, many cases of lung disease are incorrectly attributed to the workplace. "There is such public awareness now of toxic substances. People assume that if they're sick, it must be work-related," says Smith, who is also a clinical professor of medicine at the University of Washington School of Medicine. "Our culture assumes that everybody must be healthy, and if they're not, then there's something wrong with the workplace."

Employers and safety professionals can do a little homework and save themselves and their employees some grief down the road, Smith says. For example, examine the locations in your facilities where claims are originating. Are they all related to one process or area of your facility? Smith suggests conducting industrial hygiene monitoring and taking quick corrective action if you find a problem.

Questioning employees is also useful, he says. "Certain industries 'sort' employees. Only healthy people can stay in the job. Maybe a new person comes in and can't take it. It's hard when you've just got one case of something; that's not really a red flag," he says. If you talk to other employees in that area and they admit they had a problem at first but "got used to it," that's your red flag, he adds.

Smith lists other red flags:

* A cluster of workers' compensation cases. Take a hard look at those cases and determine if the problem is the work environment (new processes, the addition of new chemicals, etc.) or interpersonal (a universally disliked supervisor, for example).

* Employees from one area taking a lot of sick days. Ask yourself: Has a process changed? Is there a flu virus going around? Is there an interpersonal problem that needs attention? …