ABSTRACT
Occupational and environmentally induced airways diseases are a common problem for the primary care practitioner as well as the pulmonologist. These disorders may often be unrecognized or misdiagnosed, sometimes with serious consequences. For example, the patient with toluene diisocyanate (TDI)-induced asthma who returns to work in an automo bile body shop may develop steroid-dependent asthma, fixed airways obstruction, and serious disability. This chapter outlines the approach to patients with airways disorders associated with environmental or occupational exposures. Some pulmonary airway disor ders that are affected by environmental exposures are not included in this chapter. For example, any of the obstructive lung diseases discussed elsewhere will be adversely af fected by inhalation of cigarette smoke and common air pollutants. Rather, we focus on those disorders whose exposure is more commonly occupational or accidental rather than routine.
