SPORTS INJURY How to tackle it EXERCISE The power of Pilates ...

28 N E HEALTH OCCUPATIONAL DISEASES: Advertising FeatureLUNG DISEASES AND CHEST CONDITIONSEmphysema – the air sacs (alveoli) ofthe lungs, through which oxygen isabsorbed into the bloodstream, becomeenlarged, damaged and lose theirelasticity. Air becomes trapped and thelungs over-inflated so sufferers struggle toforce air in and out. The main symptom isdisabling breathlessness, as well asfatigue and weight loss.Chronic bronchitis – the bronchi, themain airways that lead from the trachea(windpipe) into the lungs, becomeinflamed.Chronic inflammation causes excessiveamounts of mucus – also known asphlegm or sputum – to be produced bythe bronchi. This mucus then blocks theairways and air sacs reducing the amountof oxygen available to the lungs, causingbreathlessness.The condition is often made worse byinfections such as colds and flu and aslow deterioration is likely.Treatment: there is no cure for ChronicObstructive Pulmonary Disease (combinedchronic bronchitis and emphysema) andany damage to the lungs is irreversible.Quitting smoking and avoiding dusty andsmoky environments may slow down theprogression of the disease.Pneumoconiosis (excludingasbestosis) – disease of the lungscaused by the inhalation andaccummulation in the lungs of dust,especially from coal, asbestos, or silica.Inhaled particles make the lungs graduallyfibrous, making breathing difficult. Overmany years the condition causes severedisability.Asthma – Occupational asthma occurswhen workplace exposures to particularsubstances result in a biological changein a person’s airways, known as thehypersensitive state, so that subsequentexposure to the same substance triggersan asthma attack. Once the airwaysbecome hypersensitive the disease isirreversible.Prolonged exposure over months oryears can lead to chronic long-term lungdisease including chronic bronchitis,pulmonary fibrosis and emphysema.Symptoms include coughing, wheezing,breathlessness and a tightness in thechest and disturbance of sleep; in severecases, impaired physical activity andquality of life, and grossly restrictedemployment prospects.Studies show that in most casesasthma develops in six to 12 months butmay occur within ten days of the exposureor even after as long as 25 years later.Indicators of occupational asthmainclude a cough or wheeze that improvesaway from work, working in a high riskoccupation, worsening of pre-existingcontrolled asthma and newly diagnosedasthma in an adultThe newGovernmenttelevisionadvertisingcampaign,which usesshocktactics topoint up thedangers ofpassivesmokingThe real costof smokingBreathing in second hand smoke at work currently kills three timesmore people every year than die in ‘conventional’ industrial accidentsWERE a stranger to walk into atown centre pub and releaseradioactive poison overdrinkers standing at the bar,he’d be considered a terroristarmed with chemical weapons.Security would be stepped up with bagsearches for customers and perhaps a dropdownsafety shield to protect staff behind thebar in the future.Yet bar workers are exposed every day totoxic fumes, including radioactive polonium210, released around them by the smokers whocome into their pub. Long-term, continued exposureto chemicals like arsenic, benzene, embalmingfluid and rat poison, which are amongthe 120 officially classified poisons in cigarettes,can prove fatal.Breathing in second hand smoke at workkills three times more people every year thandie in “conventional” industrial accidents –that’s 600 people whose deaths were avoidableand whose lives cost nothing to protect.Death by second hand smoke is rarely talkedof in the same way as emphysema or mesothelioma,but it is considered an industrial disease.Darcy Brown, stop smoking advisor withDarlington Primary Care Trust, says employerscan no longer claim ignorance when itcomes to protecting their staff from other people’scigarette smoke.“Employers have a duty to act and preventexposure to smoke. The Health and Safety atWork Act says employers must take all reasonablesteps to protect their staff from risk,”she says. “If you are knowingly allowing yourstaff to be exposed continuously to the 60 cancer-causingchemicals in cigarettes then surelyyou are breaking the law.”As well as inhaling multiple carcinogens,chemicals in cigarettes also break down thebody’s immune system to fight the poisons.The biggest cause of death among smokersand those who breathe in smoke are heart attackand stroke caused by carbon monoxide,which has been shown to reduce blood flow tothe heart within 30 minutes of exposure tosmoke.The NHS says more than 80 per cent of casesof chronic obstructive pulmonary disease aredue to cigarettes and 25,000 limb amputationsare carried out every year on smokers.Some studies have found that the greateryour exposure to second hand smoke at work,the greater your risk of lung cancer – for thoseexposed for more than 21 years, the risk of cancerincreases by 25 per cent.They are claims challenged by smokers’lobby group FOREST, whose supporters includeTV chef Anthony Worrall Thompson andartist David Hockney. FOREST’s president,Lord Harris of High Cross, says worldwidestudies over 25 years have failed “spectacularly”to establish any “significant link betweenlifetime exposure to environmental tobaccosmoke and lung cancer in non-smokers”.For an employee to prove their health problemsare a direct result of second hand smokeis not easy, but successful cases have beenbrought.Michael Dunn was reportedly paid up to£50,000 by a London casino in an out-of-courtsettlement after claiming he developed asthmabecause of passive smoking at work.In 1993, Stockport Council had to pay £15,000when years of passive smoking at work wasshown to have caused Veronica Bland’s chronicbronchitis.Already behind New York, Ireland, NewZealand and Australia, the Government’s publicconsultation exercise on smoking in publicplaces ended earlier this month. Submissionshave been made on four options including allowingthe voluntary smoking ban approach tocontinue and handing down responsibility forsmoking policies to local authorities.A ban with exemptions for premises thatdon’t sell food is another option. In Darlington,for example, this would mean 48 per cent ofpubs would be unaffected and smoking wouldcontinue.“The purpose of any change is health improvement,”says Mr Brown, “but if this optionwere chosen it would actually widen the currentinequalities in health. The majority ofpremises that would fall into this category,where the workforce and customers would continueto be unprotected, are in areas of thetown which already have a poor health record.”His view is backed by the Trades Union Congress,which is also pushing for an outrightban. The TUC says: “The current legislationwhich exempts pubs and bars not serving food,will leave workers who need it the most (in approximately30,000 pubs and private clubs) nobetter protected. The absence of a full ban willalso have a disproportionate impact on theNorth-East which has more of these pubs andclubs than most other parts of the country.”The option favoured by the Smoke FreeNorth-East campaign is a ban on smoking inany enclosed public place. Mr Brown says:“This would essentially cover most places ofwork and would therefore offer equal protectionto everyone, including people who workin the hospitality industry.“If the government follows our recommendation,the majority of work places would becomesmoke-free. In those circumstances I haveno doubt that employers will see reduced absenteeism,increased productivity and reducedcosts in areas like insurance andcleaning.”