The Residual Effects of Occupational Exposures Among Rural Residents

While a number of efforts have been made to improve air quality and air safety at industrial and minerals/mining businesses in rural areas like Steuben County, health care providers continue to see the lingering effects of these exposures in their patients.  In Sept. 2009, Dwight Casey Miller, aged 58, died of silicosis at Corning Hospital.  Silicosis is a progressive lung disease that is generally related to work exposures to silica dust, including "hard-rock mining, silica milling, quarrying and stone work, foundry work (quartz sand is used to make molds), sand blasting, pottery making, glass making, and cleaning boilers."  I was unable to find where Mr. Miller had worked, but a number of these trades are common to Steuben County residents.  Along with emphysemic trapped pockets of air, there is fibrotic development in affected lungs in silicosis: "Silicotic nodules are made of centrally located whorls of collagen and reticulin with surrounding macrophages, fibroblasts, mast cells, and lymphocytes."  The foremost treatment is to avoid exposure, including in patients that have yet to develop marked symptoms.  Once symptomatic, other than avoiding further exposure, most measures are supportive: supplemental oxygen and sometimes steroids can bring some relief.

Rural physicians treating individuals with shortness of breath and chronic bronchitis need to be aware of silicosis as a possible diagnosis, and carefully review the patient's occupational history to see if they have any exposure to airborne irritants/carcinogens such as silica dust or asbestos which may explain their patient's symptoms.

Medical source:  Carrier D.D., Newman L.S. (2003). Chapter 31. Pneumoconiosis. In M.E. Hanley, C.H. Welsh (Eds), CURRENT Diagnosis & Treatment in Pulmonary Medicine. Retrieved September 10, 2012 from http://www.accessmedicine.com/content.aspx?aID=577842.

[reposted from Facebook; from March 1, 2012]
In its most recent Community Health Assessment, Steuben County identified chronic disease as a priority area. Towards that end, two Steuben members of the Southern Tier Diabetes Coalition recently received a grant to travel to the CDC for d

iabetes prevention training. One of the grantees was from the Steuben Rural Health Network, which provides diabetes prevention services through their Lifestyles Embracing Activity & Nutrition (LEAN) program. I have already covered their youth program, BodyWorks, but they also run an online community, a program for pre-school aged children, and an adult worksite wellness program. By directing their efforts across the community, Steuben County Health Dept. and Steuben Rural Health Network can reinforce the messages that they are giving children and their parents.