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Seeking Medical Advice for Occupational Disease

Individuals that experience symptoms associated with occupational diseases should seek medical advice as soon as they notice symptoms.  The sooner these types of diseases are diagnosed and treated the better the prognosis is for patients.

There are doctors who specialize in occupational medicine but they are very rare.  Of the 800,000 physicians in the United States only 10,000 of them specialize in occupational medicine.

The first point of contact for most individuals is the family physician.  This physician should do a thorough screening and can assist patients in recognizing the possibility of an occupational illness.  Providing the physician with information about workplace irritants will help attain an accurate diagnosis.

Individuals should also consult the “materials supervisor” at the workplace.  This person should be able to give detailed information via a “materials safety data sheet” about the types of toxic compounds found at the work site.

Occupational illnesses tend to be diagnosed infrequently however, they are responsible for approximately 860,000 illnesses annually.  These illnesses lead to 60,300 deaths in the United States every year.  Detecting, diagnosing and treating these diseases in the earliest stages may increase the chance of reversal and/or survival.

It is also important to be aware of dangerous substances prior to beginning a job and to ensure that proper protection is available.   Prevention is the best means to avoid lung and respiratory disease and proper equipment may keep workers safe from dangerous airborne particles.  Respirators, proper ventilation and other types of equipment should be provided on the job.

Symptoms of occupational lung diseases

Occupational lung and respiratory diseases have a wide variety of symptoms. These symptoms may seem insignificant at first but anyone who suspects on-the-job exposure to dangerous substances should seek medical advice. The most common symptoms of lung disease may not be highly indicative of lung disease at all. The symptoms often resemble other medical conditions and therefore are more difficult to diagnose.

What to do if you experience these symptoms?

According to the American Academy of Family Physicians a person who suspects workplace exposure to harmful substances should keep a written record of all symptoms. The record should include when the symptoms began and the frequency of occurrence. The individual should also keep track of the times when symptoms are most severe and how those times relate to their personal work schedule. A list of possible workplace hazards, as well as any required safety procedures should also accompany this record. It would also be prudent to speak with other employees to see if they are experiencing similar symptoms.

Persistent cough

The first symptom many individuals notice is a persistent cough. The cough may be dry or productive and continues without relief. Shortness of breath, especially when doing minor tasks or daily duties may often follow. This shortness of breath is persistent and begins to make routine living more difficult. Some individuals may experience a scratchy throat or runny nose accompanied by a fever. These symptoms may be a sign of a work-related disorder if they are noticed soon after beginning a new job or being moved to a new location.

Tightness in the chest

A persistent tightness in the chest may also be a sign of a serious lung disease. Chest pain may also accompany this tightness and will often continue to worsen. Individuals with lung or respiratory diseases may experience abnormal breathing patterns or worsening shortness of breath. These symptoms may often come and go or may be persistent.

Wheezing or trouble breathing

Adults that develop asthma for the first time should consider that a workplace irritant might be the cause. Symptoms of asthma include wheezing or trouble breathing and a persistent dry cough. Asthma that is left untreated can become serious and sometimes even fatal.

Fatigue

Another serious lung disease, emphysema, can be caused by on-the-job exposure to dangerous dusts. The symptoms of emphysema are cough, difficulty breathing and fatigue. Emphysema is a chronic lung condition and there is no known cure. The symptoms often worsen until breathing with the help of oxygen is necessary.

Additional symptoms

Other symptoms may include swelling in the abdomen or changes in bowel habits. These symptoms may indicate a serious disease such as peritoneal mesothelioma, caused by exposure to asbestos. Additional symptoms such as sudden weight loss, pain in the abdomen, coughing up blood and chronic respiratory infections may also indicate serious respiratory or lung disease.

More on prevention of occupational diseases

Government agencies also help in the prevention of occupational disease by posing regulations on workplace safety. In 1970 the government established laws that created two National health agencies. The first, the National Institute for Occupational Safety and Health (NIOSH), was formed to oversee and research safety in workplace activities. This agency was established within the U.S. department of Health and Human Services (USDHHS). The second agency was established within the U.S. Department of Labor. The Occupational Safety and Health Administration (OSHA) was designed to set government standards for health and safety in the workplace and also enforce these standards.

NIOSH has created the National Occupational Research Agenda (NORA) which is a comprehensive list of areas that address workplace dangers. This agenda explores toxicology, identifies emerging technology dangers and evaluates how the combinations of substances in the workplace may effect workers. The reports garnered from this research may help to provide insight into new and dangerous substance as they arise.

Occupational irritants are found worldwide and the knowledge of their danger has helped to decrease the occurrence of disease in many industrialized nations. These developed countries such as the United States have begun major prevention programs. Unfortunately, less developed nations are just beginning to see the effects of imported, dangerous materials. It is the hope of world organizations such as the World Health Organization and the International Labor Office to begin prevention programs worldwide to help stop these diseases.

 

More on Harmful Materials

Fumes

Fumes such as those given off during welding, smelting, rubber and plastic manufacturing, pottery making and other industries where items are heated and rapidly cooled can also be dangerous. These fumes often irritate the eyes, throat and nose before they enter the lungs. Exposure to these fumes can cause immediate symptoms or symptoms can present day, weeks or even years later.

Agricultural toxins

Agricultural toxins including those found in grains, hay and animal dander pose a health risk to workers. The mold, hair, feathers and bacteria often found during farming and other agricultural pursuits can cause respiratory illnesses.

Vapors

Vapors given off by solvents, paints, cleaning agents, hair sprays, pesticides and other products that cause irritation to the nose and throat can also affect the lungs. These vapors usually cause immediate discomfort to the nose and throat but after prolonged exposure can damage the lungs causing disease.

Latex

Latex allergies have become more and more prevalent in the United States due to the required use of gloves for healthcare workers. Latex related asthma now affects 1 in 50 healthcare workers.

Crystalline silica

The dust from crystalline silica can also be the cause of lung disease. The dust is found in the air in mines, around blasting operations and in manufacturing facilities that produced stone, glass and clay. In the U.S. nearly two million workers are exposed to “respirable silica”. The National Institute for Occupational Safety and Health (NIOSH) states that hundreds of individuals become disabled each year from silicosis and approximately 250 deaths can be attributed to the disease annually.

Hemp, Flax and Cotton

The dust from hemp, flax and cotton processing has also been found to be dangerous.

Radon

Radon is an odorless, colorless gas that occurs naturally and can affect indoor air quality. This gas can accumulate in confined spaces and cause the air to be polluted. Radon is a worldwide problem and can be found in spring waters as well as hot springs. The U.S. Environmental Protection Agency reports that radon is the second leading cause of lung cancer and the 6th leading cause of death by cancer causing more than 21,000 lung cancer deaths in the U.S. every year.

Lead

Lead poisoning is the oldest known occupational health hazard. It has been noted as harmful to humans for 2,000 years yet is still prevalent in industry today. Lead fumes or lead dust particles are the dangerous forms of the mineral that can lead to disease. Manufacturing industries from plastics to chemicals can cause lead exposure. Other dangerous jobs can include gas station attendants, jewelers, lead miners, firing range instructors, battery manufacturing workers, construction and demolition workers, welders and a host of other jobs.

Harmful Materials

The Center for Disease Control and Prevention along with The American Lung Association and American Academy of Family Physicians has compiled a lit of possible on-the-job irritants that may cause respiratory and/or lung disease. The American Lung Association makes two names two distinct classes of occupational lung disease: pneumoconiosis, diseases contracted by inhaling dust into the lungs, and hypersensitivity diseases, like asthma, that occur when the lungs overreact to particular airborne pollutant. Bronchitis, lung cancer and byssinosis are also classified as occupational lung disease. The following list includes many of the dangerous substances found in workplaces in the United States and around the world. There may be others that are still being discovered.

Asbestos

Asbestos is a naturally occurring mineral that was used in many industries before it was discovered to be dangerous. Today, it can be found in homes, offices, hospitals and schools and poses a serious health risk to those who are exposed. Asbestos is not dangerous unless it is released into the air where the fine particles are breathed into the lungs. Workers in industries such as mining, construction, demolition and electrical work are most at risk. Since the mid-1970’s asbestos use has been highly regulated by the government. The American Lung Association sites 2,000 to 3,000 new cases of cancer develop each year due to asbestos exposure.

Dust and particulate matter (PM)

Dust or particulate matter (PM) from materials such as wood, cotton, asbestos, coal, silica and textile manufacturing can be dangerous. Particulate matter is simply small particles released into the air that can potentially cause lung disease. This may include a combination of dust, mold, dirt, soil and ash. The sources of particulate matter are factories, car exhaust, mining, farming and construction. The particles released from these sources become airborne and are breathed into the lungs where they can cause severe damage. The smaller the particles the more damage they can do within the soft tissue of the body.

 

To  be continued in a future post.

 

Survival statistics: disease-free and progression-free

For calculating five-year relative survival rates, all those individuals are included who may still be living for five years after cancer is detected. These include patients who may be in remission (brief or permanent absence of cancer), or those who may still be receiving treatment. More specific survival statistics, for example, disease-free and progression-free survival statistics, are generally used to evaluate cancer treatments.

  • Disease-free survival rates describe only that percentage of patients who may have achieved a complete remission after the completion of treatment.
  • Progression-free survival rates refer to the percentage of patients with no new tumor growth or cancer spread for the duration of and after treatment. These include individuals whose disease may have either responded partially or completely to treatment, or those with a stable disease (the cancer still exists, but has stopped advancing).

Survival statistics and the theory of “cure”

In the medical world, a disease is said to have been cured when it is treated successfully and does not reoccur. It is difficult to apply the concept of “cure” to cancer because in specific cases, some cancer cells can remain undetected. These cells can cause the cancer to return after a certain period of time (called relapse or recurrence). Most types of cancers are categorized as “cured” if there is no relapse or recurrence of cancer five years after cancer is detected. However, a relapse can occur even after five years.

Predicting prognosis

When cancer is diagnosed, one of the most common questions people ask is whether or not the cancer can be successfully treated. This is referred to as a prognosis – the expected course of cancer, its potential outcome and the patient’s chances of recovery. To make a prognosis, doctors usually rely on survival statistics. For instance, it can be said that an individual diagnosed with testicular cancer has a favorable prognosis because the overall five-year relative survival rate, as relevant to testicular cancer, is 95%.

As with survival statistics, a prognosis is based on the cancer’s stage at the time of diagnosis – how early the diagnosis has been made and the cancer’s spread, if any. For instance, if an early diagnosis is achieved, the five-year survival rate, as relevant to colorectal cancer, is more than 90%. For colorectal cancer patients in advanced stages of the disease (cancer that has spread to other areas of the body), the five-year relative survival rate is around 10%.

Important Points to remember

  • Statistics only provide an estimate of trends prevalent amongst large population groups. They are not indicative of what actually may happen to an individual.
  • Survival statistics, as relevant to different stages of cancer, age groups, or time durations, can vary significantly. People need to talk to their doctor about the most appropriate statistics, as relevant to their specific medical condition.
  • As with most other types of medical information, ask your doctor to provide a clarification in case cancer-related statistics appear unclear to you.

Evaluating treatment choices

Five-year relative survival rates allow doctors to evaluate and compare available treatment options. While an individual who is still living five years after diagnosis cannot be described as being completely “cured”, the five-year relative survival statistic does indicate that the disease is responding properly to treatment. It also shows that the treatment is helping extend the cancer patient’s life. Using survival statistics, doctors can determine which treatment protocol will prove most beneficial for cancer patients, and whether the associated benefits of a treatment will outweigh its potential risks (for example, discomforting side effects).

Important points to remember

  • Since five-year survival statistics relate to patients who may have received treatment at least five years earlier, they may not be indicative of the latest, more advanced treatment options.
  • While survival statistics provide valuable information for evaluating treatment options, they should only be used as a specific component of a comprehensive treatment plan devised by a doctor who is well aware of the patient’s individual condition.

Prevention is the Best Defense

Preventing occupational lung and respiratory diseases is the most significant way to reduce the number of deaths from these illnesses. The most effective way to prevent these diseases is to avoid inhaling the substances that cause them. Limiting or eliminating exposure to these irritants is the only way to decrease their effects on the body. Some preventive measures recommended by the National Heart, Lung and Blood Institute (NHLBI) include:

  • Wear protective gear such as facemasks, respirators, or other garments that will prevent inhalation of dangerous airborne particles.
  • Follow specific government guidelines in removal or repair of dangerous substances such as asbestos.
  • Do not smoke cigarettes as the use of tobacco can increase the risk of developing lung and respiratory disease.
  • Make routine visits to a physician to have lung function evaluated with spirometry.
  • Become familiar with any dangerous substances that may be present in the workplace and know the risks associated with them.

The lungs and the tissue leading to them are the body’s first organs to come into contact with outside air. The lungs are susceptible to many irritants due to the constant breathing in and out. The particles in the air can cause damage and leave individuals permanently disable and sometimes lead to death. The diseases caused by these particles are almost entirely preventable. Using the measures listed above as well as following workplace guidelines may help worker’s avoid these life-changing diseases.

 

Using Survival Statistics to make a Prognosis and Determine Treatment Options

When diagnosed with cancer, the first thing most people want to know is their overall chance of recovery and survival. They may also be interested in knowing how they can use this information to choose from available treatment options. While it is extremely important to understand survival statistics, it can be confusing sometimes. Using survival statistics, doctors can also make a prognosis and evaluate treatment options.

Five-year relative survival rates

Generally given as rates, survival statistics describe the percentage of individuals (diagnosed with a particular type of cancer and stage) who will be alive for a specific period of time after the diagnosis is made. Survival rates can be expressed for any time duration. Cancer statistics are generally expressed as a five-year relative survival rate. It describes the percentage of cancer patients who will survive for five years after cancer is detected (excluding individuals whose deaths that may be caused due to other diseases). For instance, the five-year survival rate, as relevant to cervical cancer, is 72%. This implies that 72% of women diagnosed with cervical cancer will be alive for 5 years after cancer is detected.

Survival statistics are generally calculated for specific stages of cancer (cancer stage describes the presence and extent of the cancer’s spread) since these statistics vary based on stage. For instance, the five-year relative survival rate, as relevant to early-stage bladder cancer (as of 2008), is 95%. However, the five-year relative survival rate for individuals diagnosed with advanced stages of cancer is 16%. Survival statistics that cover all the different stages of cancer are called an overall rate. For example, the overall five-year relative survival rate, as applicable to cases of prostate cancer (irrespective of stage), is 98%.

Lung Cancer Survival Rates

When diagnosed with cancer, the most common question people generally ask is about their prognosis. It’s likely that you would want to know if a cure for your cancer will be easy to come by or will be relatively more difficult. Your doctor may not be able to predict the future, but you can get an estimate based on the medical history of other individuals diagnosed with the same type of cancer.

It’s your decision whether you want to learn more about the survival rates pertaining to your cancer. The statistical data can be confusing and alarming.

Defining cancer survival rates

Expressed in percentage terms, overall cancer survival rates depict the total number of individuals who survive a particular form of cancer for a specific period of time. Generally, a five-year survival rate is used as a yardstick. For instance, the overall survival rate for prostate cancer is 98 % (based on a five-year term). It implies that out of the every 100 individuals diagnosed with prostate cancer, 98 manage to survive 5 years after the diagnosis was made. It also implies that 2 individuals die within five years out of every 100 diagnosed with prostate cancer.

Survival rates of cancer are ascertained through research based on information derived from hundreds or thousands of individuals diagnosed with cancer. Individuals belonging to all age groups and with varying health conditions are included for ascertaining an overall survival rate. This also includes individuals who were diagnosed early and those with a late diagnosis.

Based on the stage of cancer, your doctor can provide you with more specific statistics. For example, 49 percent or about half of those diagnosed in the early stages of lung cancer, live a minimum of 5 years after diagnosis. For individuals whose lung cancer has spread (metastasized) to other parts of the body, the five-year survival rate is 3 percent.

However, overall cancer survival rates do not indicate whether cancer survivors may still be receiving treatment or if their cancer has been cured completely (achieved remission). More specific information can be obtained from some other types of cancer survival rates such as:

  • Disease-free survival rate: Indicates the total number of cancer patients who achieve remission. It implies that there are no visible signs of cancer in these people.
  • Progression-free survival rate: Indicates the total number of individuals with cancer, whose disease is not progressing. This may include individuals who may have had experienced some success with cancer treatment, but still their cancer exists.

What are the practical uses of cancer survival rates?

You and your doctor can use cancer survival rates to:

  • Learn about your prognosis: The medical history of other individuals diagnosed with the same type of cancer can provide you and your doctor more specifics about your prognosis (the possibility of achieving remission). Your doctor may also include other factors such as your overall health and age to help you understand the gravity of your specific condition.
  • Select a treatment plan: Statistical data can also indicate how individuals with a similar condition respond to cancer treatment. Using this information in addition to your own individual goals for treatment, you can find out the advantages and disadvantages of each treatment option. For example, if two treatment plans offer equal chances of achieving remission, but have varying side affects, you can select the treatment plan having fewer side-effects.

What is not revealed through cancer survival rates?

At times, cancer survival rates can be annoying since they cannot provide specific information about you. The rate of survival associated with a particular type of cancer may be based on information sourced from thousands of people. You may get a general idea about most individuals with a similar condition, but it will be difficult to point out your individual chances of achieving remission. Since this can be disappointing, some individuals choose to disregard statistics related to cancer survival rates.

Cancer survival statistics do not factor in details such as your medical condition. For instance, if you otherwise have good health, you will have more chances to survive than what the statistics might indicate. Conversely, if you have other serious medical conditions, your chances of survival may be less than statistical numbers. However, your doctor can provide more accurate approximations based on your specific condition.

There are also other limitations associated with survival rates. For example, they may not:

  • Provide information about the most recent treatments: The existing cancer statistics are based on information gathered from cancer patients who were diagnosed at least five years earlier. It implies that new treatment discoveries will not effect any changes in the survival rates for a minimum of five years.
  • Tell you about what treatment plans to select: This depends entirely on your individual decisions and that of your doctor. Some patients may choose treatments offering the highest chances of achieving remission whereas other may make their selection based on factors such as treatment schedule and associated side effects.

Researchers Identify Genes Linked to Length of Cancer Survival

Six gene markers have been identified that may help doctors predict length of survival time for patients with non-small cell lung cancer, according to researchers at Wake Forest University School of Medicine.

These gene markers may also help oncologists predict the effectiveness of different drug treatments and alter therapy suggestions on a case-by-case basis.

Presently, it is estimated that 30 percent of small-cell lung cancer patients will experience a relapse within five years of initial surgery and chemotherapy treatment. As such, knowing which patients are most likely to experience a relapse could spur oncologists to order additional chemotherapy sessions for those at the highest risk.

Indeed, this improved prediction is exactly what the research team was looking to achieve. According to Lance Miller, lead author for study, “The goal of the project was to develop a personalized approach to the selection of patients with early stage lung cancer for whom more aggressive therapy may provide a survival benefit.”

To identify the six-gene biomarker, Dr. Miller and team first profiled the genes of hundreds of patients with stage I non-small cell lung cancer. Using these samples, the team then identified the six-gene set that could be directly linked to low-, intermediate- or high-risk for relapse.

To validate these lab findings, a cohort trial was run to compare survival rates of 179 patients based on classification of low-, intermediate- or high-risk. Results of this cohort concluded that surgical removal of the lung cancer tumor alone was not adequate treatment for those in the high-risk category.

Lung cancer is currently the leading cause of cancer death in the United States, with an estimated 170,000 new cases diagnosed each year. Additional prospective validation of the Wake Forest findings is required before the pre-screening method is approved and endorsed by health authorities.