Our lungs are the interface between blood and air. Their role in oxygenating our bloodstream is their primary function, and they endure much more than just oxygen and carbon dioxide pressures. The air contains many chemicals, pollutants and particles that can cause many types of lung diseases.
Pollution in city centers can lead to the inhalation of gases, including nitrogen dioxide, which affect other respiratory diseases such as asthma. Coal dust caused a disease in miners known as emphysema – known today as chronic obstructive pulmonary disease.
But some inhaled particles can cause their own illnesses with unusual names and are more common in people who have certain jobs — or even certain hobbies. Asbestos is perhaps the best-known example.
The history of asbestos is long and ultimately malign. It is a natural substance – a strong, durable, heat-resistant material – that was once widely used in the construction industry and shipbuilding.
When asbestos breaks down, it releases fibers into the air that can easily be inhaled. As it migrates through the respiratory tract, it can first affect the lungs, generating a form of scarring that prevents them from inflating normally. This is called asbestosis.
It can also travel outward to irritate and thicken the pleura (the membranous lining of the lungs), preventing them from expanding further.
Perhaps the worst association is that between asbestos and the aggressive form of cancer known as mesothelioma – which is serious and unfortunately incurable.
The spectrum of patients with asbestos-related illnesses is also not limited to men working in the workplace. Many wives who washed their husbands’ dirty clothes were also exposed, as were the children who shared the house.
The first established diagnosis of asbestosis was in 1924. What is staggering is the delay between the first recognition of asbestos-related disease (and even death) in the early 1900s, before its use was eventually banned in some countries in the 1980s and 1990s, with its removal and disposal carefully regulated.
Birds, brass and blue cheese
It’s not just your job that can put you at risk of developing certain lung diseases. Sometimes it’s the things you do in your free time.
Take for example bird enthusiasts, those who keep pigeons for racing or keep birds at home as pets. If you are such a person, stay alert for chest symptoms such as persistent cough or shortness of breath, and take them seriously if they appear.
The condition we are examining here has the elaborate name Extrinsic Allergic Alveolitis, or EAA. In a nutshell, inflammation of the tiny air sacs in the lungs (the alveoli) generated by an allergic response to an alien particle entering the body. It shares several characteristics with asbestosis: a cough, chest tightness and shortness of breath.
EAA can be diagnosed by radiographic imaging. On a chest x-ray, the lung fields have a blur that looks like ground glass. It can also be studied with blood tests and a special breathing test where the patient blows into a tube to measure their lung volumes and airflow during exhalation. We call this spirometry.
Let’s get back to feathered friends and the problems they can cause.
Dust from bird feathers and droppings contains avian proteins that can inflame the lungs when inhaled. These can come from various species of birds. It is observed among pigeon breeders, but it can also be observed among poultry breeders and those who sell and breed birds. Even keeping small birds, like canaries or budgerigars, can pose a risk, as can larger birds, like cockatiels and parrots.
EAA has causes other than repeated inhalation of bird particles. The list is both long and original, including a variety of allergens from many areas.
Take the culinary industry as an example. Imagine inhaling the mushrooms from the rind of blue cheeses and contracting the cheese washer’s lung. Or even the fungi resulting from grape mold and the development of winegrower’s lung. Similar particles can break off from coffee beans, molasses sugar, mushrooms and barley, each creating its own form of respiratory illness.
Those who work with dried grass or hay – farmers or thatchers, for example – may also find themselves victims of other inflammatory fungi. Other sources include sawdust, fertilizers and moss.
It also appears that playing music or bathing in the spa is not completely risk-free. Bacteria related to those that cause tuberculosis can be inhaled through a wind instrument or through bubbling water. They are also colloquially called brass player’s lung and spa lung.
Marco Destefanis/Alamy Stock Photo
Most of these conditions can be treated with steroids, but the main goal is to avoid exposure to the allergen in question. For some, it’s easier than for others. Getting rid of a beloved pet can be as difficult as changing careers.
Part of the difficulty may be determining the cause of the problem. This is why it is always important for a doctor to ask questions about their profession and hobbies during a consultation about respiratory symptoms.
So don’t underestimate the impact of the air we breathe on our lungs. The air of the city and the countryside can exert its influence.