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Recent Advances in Chest Medicine |

Frontiers in Occupational and Environmental Lung Disease ResearchFrontiers in Occupational Lung Disease Research

Saeher A. F. Muzaffar, MD; David C. Christiani, MD, FCCP
Author and Funding Information

From the Division of Pulmonary, Allergy, and Critical Care Medicine (Dr Muzaffar), Hospital of the University of Pennsylvania, Philadelphia, PA; the Departments of Environmental Health and Epidemiology (Dr Christiani), Harvard School of Public Health; Harvard Medical School (Dr Christiani); and the Division of Pulmonary and Critical Care Medicine (Dr Christiani), Massachusetts General Hospital, Boston, MA.

Correspondence to: David C. Christiani, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, 665 Huntington Ave, SPH I-1407, Boston, MA 02115; e-mail: dchris@hsph.harvard.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2012 American College of Chest Physicians


Chest. 2012;141(3):772-781. doi:10.1378/chest.11-0156
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Two central challenges in the field of occupational and environmental epidemiology include accurately measuring biologic responses to exposure and preventing subsequent disease. As exposure-related lung diseases continue to be identified, advances in exposure biology have introduced toxicogenomic approaches that detect biomarkers of exposure at the gene, protein, and metabolite levels. Moreover, genetic epidemiology research has focused more recently on common, low-penetrant (ie, low-relative-risk) genetic variants that may interact with commonly encountered exposures. A number of such gene by environment interactions have been identified for airways and interstitial lung diseases, with the goal of preventing disease among susceptible populations that may not otherwise have been identified. Exhaled breath condensate analysis has provided another noninvasive means of assessing toxicant exposures and systemic effects. As these technologies become more refined, clinicians and public health practitioners will need to appreciate the social implications of the individual- and population-level risks conferred by certain genetic polymorphisms or by biomarker evidence of exposure. At present, the primary approach to occupational and environmental lung disease prevention remains elimination or reduction of known hazardous exposures and requires continued application of local and international resources toward exposure control.


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