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Harrison's Principles of Internal Medicine, 18e | Part 11. Disorders of the Respiratory System > Section 2. Diseases of the Respiratory System > | Chapter 256. Occupational and Environmental Lung Disease Sections: Occupational and Environmental Lung Disease: Introduction, Occupational Exposures and Pulmonary Disease, General Environmental Exposures, Further Readings. Topics Discussed: occupational lung disease. Excerpt:"Occupational and environmental lung diseases are difficult to distinguish from those of nonenvironmental origin. Virtually all major categories of pulmonary disease can be caused by environmental agents, and environmentally related disease usually presents clinically in a manner indistinguishable from that of disease not caused by such agents. In addition, the etiology of many diseases may be multifactorial; occupational and environmental factors may interact with other factors (such as smoking and genetic risk). It is often only after a careful exposure history is taken that the underlying workplace or general environmental exposure is uncovered.The patient's history is of paramount importance in assessing any potential occupational or environmental exposure. Inquiry into specific work practices should include questions about the specific contaminants involved, the presence of visible dusts, chemical odors, the size and ventilation of workspaces, the use of respiratory protective equipment, and whether co-workers have similar complaints. The temporal association of exposure at work and symptoms may provide clues to occupation-related disease. In addition, the patient must be questioned about alternative sources of exposure to potentially toxic agents, including..."
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