Preface
321
Preface
Environmental Lung Diseases—2015 William N. Rom, MD, MPH1
Joan Reibman, MD1
1 Division of Pulmonary, Critical Care, and Sleep Medicine,
Departments of Medicine and Environmental Medicine, NYU School of Medicine, New York, New York
Occupational lung diseases have been remarkably controlled since health regulations, promulgated in the 1970s, resulted in reductions in exposures and substitutions with less hazardous products. Environmental health has also made progress in industrialized nations with reductions in particulate matter air pollution, although ozone remains a persistent challenge. This issue on Occupational and Environmental Pulmonary and Bronchiolar Disorders addresses the continued environmental risks to the human lung that exist despite these improvements. The over-riding present and future challenge to our environmental health stems from carbon pollution with 2014 reported as the hottest year on record by National Aeronautics and Space Administration (NASA) and National Oceanic and Atmospheric Administration (NOAA). The source of this heat is the greenhouse gases (GHG) emitted by fossil fuel consumption; there has been a 40% increase in atmospheric CO2 since records began in 1959. Methane now accounts for 9% of greenhouse gases. Although methane is a short-lived GHG, it has more than 80 times greater global warming potential over a 20-year period than CO2. Sources of methane include oil and gas production, landfills, and agriculture. Methane is the major component of natural gas, which is increasingly replacing coal-fired power plants as an energy source, as states seek to undertake the EPA’s proposed Clean Power Plant rules. Natural gas emits half the GHG than burning coal to produce electricity and the price has plummeted as hydraulic fracking has been used to find abundant gas in U.S. shale formations. Hydraulic fracking involves horizontal drilling followed by pumping sand, water, and mixtures of a dozen chemicals selected from over 1,100 potential additives to crack the shale and release the gas. The health outcome of individuals living near these hydraulic fracking sites is considered by McCawley in this edition. Work-aggravated and occupational asthma involving the distal airway with inflammation and accompanying bronchial hyperreactivity plus
epidemiological approaches to these disorders are reviewed by FriedmanJimenez. More than 3 billion persons cook with biomass, exposing women and their children to the many compounds found in biomass smoke resulting from the burning of charcoal, wood, coal, and dung. The lack of chimneys in the rural areas of the developing world compounds this exposure. The epidemiological studies performed in the developing world among biomass-exposed and respiratory outcomes are reviewed by Akshay Sood and colleagues. Coal mine dust lung disease has been studied for decades with simple and complicated pneumoconiosis replaced by concerns on lung function changes and development of COPD. The fine coal mine dust deposits in the terminal respiratory bronchioles causing inflammation and fibrotic changes. These can be detected as small airways impairment in the silent zone of the lung. Petsonk and colleagues assess the small airway in coal mine dust exposed subjects. Interestingly, the terminal respiratory bronchiole is also the target of World Trade Center Dust and efforts to study this is chronicled by Nolan and colleagues. This may well be the site for malignant transformation and lung cancer development as well. Basal cells have the capability of self-renewal and repair environmental damage. Markowitz reviews the studies for asbestos exposure and cancer considering all of the controversies from low-dose exposure to the role of fibrosis, smoking and smoking cessation, and time from onset. The role of CT scans for early detection of fibrosis, pleural plaques and thickening, and lung cancer is reviewed by Weissman and colleagues. Christiani and colleagues review the development of disease that usually depends on an interplay of host
Address for correspondence William N. Rom, MD, MPH, Division of Pulmonary, Critical Care, and Sleep Medicine, Departments of Medicine and Environmental Medicine, NYU School of Medicine, New York, NY 10016 (e-mail: William. [email protected]).
Copyright © 2015 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212) 584-4662.
Issue Theme Occupational and Environmental Pulmonary and Bronchiolar Disorders; Guest Editors: William N. Rom, MD, MPH; Joan Reibman, MD
DOI http://dx.doi.org/ 10.1055/s-0035-1551541. ISSN 1069-3424.
This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.
Semin Respir Crit Care Med 2015;36:321–322.
Preface genetic factors and environmental exposures. There are newer exposures from nylon flock to diacetyl in butter flavorings that impact the small respiratory bronchiole and cause obliterative bronchiolitis. Kreiss and colleagues at the NIOSH Division of Respiratory Diseases in Morgantown review their experience in epidemiological studies in these disorders. Finally, surveillance for known and future occupational respiratory diseases in developing countries is developed by Antao and Pinheiro who have spent much time in Latin America studying occupational exposures. Recently, the United Nations updated the measurements of chlorofluorocarbons that are known to deplete the strato-
spheric ozone layer. Since the 1980s and the discovery of this chemical process, the Montreal Protocol has bound together nations in an effort to reduce exposure to these compounds, developing replacements and protecting the ozone layer. Surprisingly, a gigantic hole in the ozone layer occurred during the extreme cold of the Antarctic winter. The ozone hole reached a maximum of 30 million square kilometers in 2006, but in 2013 it measured only 21 million square kilometers. Such dramatic reductions can be achieved by global consensus. The reduction of occupational lung diseases is another success. However, the challenge of carbon pollution is far greater and we have to re-engineer and wean our society off of fossil fuels. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.
322
Seminars in Respiratory and Critical Care Medicine
Vol. 36
No. 3/2015
Copyright of Seminars in Respiratory & Critical Care Medicine is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
321
Preface
Environmental Lung Diseases—2015 William N. Rom, MD, MPH1
Joan Reibman, MD1
1 Division of Pulmonary, Critical Care, and Sleep Medicine,
Departments of Medicine and Environmental Medicine, NYU School of Medicine, New York, New York
Occupational lung diseases have been remarkably controlled since health regulations, promulgated in the 1970s, resulted in reductions in exposures and substitutions with less hazardous products. Environmental health has also made progress in industrialized nations with reductions in particulate matter air pollution, although ozone remains a persistent challenge. This issue on Occupational and Environmental Pulmonary and Bronchiolar Disorders addresses the continued environmental risks to the human lung that exist despite these improvements. The over-riding present and future challenge to our environmental health stems from carbon pollution with 2014 reported as the hottest year on record by National Aeronautics and Space Administration (NASA) and National Oceanic and Atmospheric Administration (NOAA). The source of this heat is the greenhouse gases (GHG) emitted by fossil fuel consumption; there has been a 40% increase in atmospheric CO2 since records began in 1959. Methane now accounts for 9% of greenhouse gases. Although methane is a short-lived GHG, it has more than 80 times greater global warming potential over a 20-year period than CO2. Sources of methane include oil and gas production, landfills, and agriculture. Methane is the major component of natural gas, which is increasingly replacing coal-fired power plants as an energy source, as states seek to undertake the EPA’s proposed Clean Power Plant rules. Natural gas emits half the GHG than burning coal to produce electricity and the price has plummeted as hydraulic fracking has been used to find abundant gas in U.S. shale formations. Hydraulic fracking involves horizontal drilling followed by pumping sand, water, and mixtures of a dozen chemicals selected from over 1,100 potential additives to crack the shale and release the gas. The health outcome of individuals living near these hydraulic fracking sites is considered by McCawley in this edition. Work-aggravated and occupational asthma involving the distal airway with inflammation and accompanying bronchial hyperreactivity plus
epidemiological approaches to these disorders are reviewed by FriedmanJimenez. More than 3 billion persons cook with biomass, exposing women and their children to the many compounds found in biomass smoke resulting from the burning of charcoal, wood, coal, and dung. The lack of chimneys in the rural areas of the developing world compounds this exposure. The epidemiological studies performed in the developing world among biomass-exposed and respiratory outcomes are reviewed by Akshay Sood and colleagues. Coal mine dust lung disease has been studied for decades with simple and complicated pneumoconiosis replaced by concerns on lung function changes and development of COPD. The fine coal mine dust deposits in the terminal respiratory bronchioles causing inflammation and fibrotic changes. These can be detected as small airways impairment in the silent zone of the lung. Petsonk and colleagues assess the small airway in coal mine dust exposed subjects. Interestingly, the terminal respiratory bronchiole is also the target of World Trade Center Dust and efforts to study this is chronicled by Nolan and colleagues. This may well be the site for malignant transformation and lung cancer development as well. Basal cells have the capability of self-renewal and repair environmental damage. Markowitz reviews the studies for asbestos exposure and cancer considering all of the controversies from low-dose exposure to the role of fibrosis, smoking and smoking cessation, and time from onset. The role of CT scans for early detection of fibrosis, pleural plaques and thickening, and lung cancer is reviewed by Weissman and colleagues. Christiani and colleagues review the development of disease that usually depends on an interplay of host
Address for correspondence William N. Rom, MD, MPH, Division of Pulmonary, Critical Care, and Sleep Medicine, Departments of Medicine and Environmental Medicine, NYU School of Medicine, New York, NY 10016 (e-mail: William. [email protected]).
Copyright © 2015 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212) 584-4662.
Issue Theme Occupational and Environmental Pulmonary and Bronchiolar Disorders; Guest Editors: William N. Rom, MD, MPH; Joan Reibman, MD
DOI http://dx.doi.org/ 10.1055/s-0035-1551541. ISSN 1069-3424.
This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.
Semin Respir Crit Care Med 2015;36:321–322.
Preface genetic factors and environmental exposures. There are newer exposures from nylon flock to diacetyl in butter flavorings that impact the small respiratory bronchiole and cause obliterative bronchiolitis. Kreiss and colleagues at the NIOSH Division of Respiratory Diseases in Morgantown review their experience in epidemiological studies in these disorders. Finally, surveillance for known and future occupational respiratory diseases in developing countries is developed by Antao and Pinheiro who have spent much time in Latin America studying occupational exposures. Recently, the United Nations updated the measurements of chlorofluorocarbons that are known to deplete the strato-
spheric ozone layer. Since the 1980s and the discovery of this chemical process, the Montreal Protocol has bound together nations in an effort to reduce exposure to these compounds, developing replacements and protecting the ozone layer. Surprisingly, a gigantic hole in the ozone layer occurred during the extreme cold of the Antarctic winter. The ozone hole reached a maximum of 30 million square kilometers in 2006, but in 2013 it measured only 21 million square kilometers. Such dramatic reductions can be achieved by global consensus. The reduction of occupational lung diseases is another success. However, the challenge of carbon pollution is far greater and we have to re-engineer and wean our society off of fossil fuels. This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.
322
Seminars in Respiratory and Critical Care Medicine
Vol. 36
No. 3/2015
Copyright of Seminars in Respiratory & Critical Care Medicine is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
