There is no therapeutic option for established CMDLD, so miners have to be identi ed earlier in the disease process. Therefore, recurring medical monitoring, including spirometry and chest radiography, is of highest importance to identify workers developing complications of CMDLD [293]. Prevention and termination of ongoing exposure is recommended. Bronchodilator therapy, oxygen supplementation, and early diagnosis and therapy of complications like tuberculosis or malignant disease are warranted.

Conclusion

With the enforcement of higher occupational safety standards in industrialized nations the incidence and prevalence of classical occupational interstitial lung diseases like sidero brosis is going down but new entities emerge such as fock worker’s disease or indium–tin oxide interstitial lung diseases, that both have been recognized only

within the last decades. Awareness to potential occupational triggers needs to be high in the diagnostic workup of interstitial lung diseases, since hazards previously thought to affect just the directly exposed worker may be of relevance for bystanders and worker’s family. Such bystander and paraoccupational diseases are frequently caused by the transport of hazardous material in the clothes of workers to other places and home. Outbreaks of paraoccupational diseases caused by beryllium and other compounds have been traced to contamination by industrial dust [25]. The most common hazardous scenario is the cleaning of contaminated work clothing at home. Consequently, the case record of patients undergoing clinical investigations to diagnose interstitial lung diseases need to be extended to occupational details of family members and possible bystander exposure by the dissemination of hazardous materials outside the workplace to recognize paraoccupational diseases. This can only be achieved by a high vigilance of medical professionals.

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