Sunday, March 26, 2006

The Luxury of Normal Lungs

We often take our bodies for granted, and it's not until a part malfunctions that we take notice of what the different parts do for us, day in and day out.

Today is officially "lung day." Few people think about the miracle of how our lungs work, and how they work for so many years without fail. We don't have to think to breath and we don't really have to think about our lungs until something goes wrong. Contrast this with the elderly patient with emphysema or chronic bronchitis who struggles to get enough air with every breath. Some of these people lug around oxygen tanks for the rest of their lives and get short of breath with minimal exertion. Their lungs are often colonized by bacteria that rarely affect someone with normal lungs.

A common reaction is "well, they smoked too much, and that's what happens when you smoke." Partly true, which is why it's painful to see that all too cool teenager with the oversized sweatshirt and the cigarette butt hanging out his mouth. Or the middle aged patient who knows smoking is bad for him, but doesn't quit because "there are people who smoked their whole lives and didn't die of cancer." But lung disease has other causes - including occupational (asbestos, silicosis, etc) and recreational (pigeon farmer's lung, etc).

What's frightening is that there are other causes of lung disease, most of which are still not identified, but may be commonplace enough to be affecting whole groups of people. Take, for example, a discussion about chronic obstructive pulmonary disease (COPD) with a colleague from China. I was informed that one of their main causes of COPD is "kitchen smoke." Now, I'm sure the abundance of cigarette smoke and the air pollution are probably potent additive factors in the development of any lung disease in that country, but "kitchen smoke" is an actual documented cause! Apparently, in developing countries, relevant sources of indoor pollution include biomass and coal burning for cooking and heating. In fact, rural women exposed to biomass fumes may be more likely to suffer from chronic lung conditions than urban women even though the prevalence of smoking is higher among the latter group! (Biomass fuels = wood and forest residues, animal manure and waste, grains, etc) And this topic isn't just a problem amongst "those third world countries."

Here's something closer to home - Microwave-popcorn factories produce a substance one would never suspect as an occupational hazard: the butter flavoring in microwave popcorn. In November 2000, the National Institute for Occupational Safety and Health launched a study of the health of workers at the Gilster-Mary Lee popcorn plant in Jasper, Mo. The study, based on 117 workers, found:

- Younger employees who had never smoked had about five times the rates of chronic cough and shortness of breath compared with a national sample.
- Current plant employees had 3.3 times the rate of airway obstruction when compared with the national sample.
- About 72% of microwave-popcorn production workers reported work-related irritation to their eyes, nose or throat.
- Workers in microwave-popcorn production reported chronic coughs, attacks of wheezing, chest tightness and shortness of breath more frequently than workers in other areas.
- Reports of doctor-diagnosed asthma and chronic bronchitis were twice as frequent as expected from national data.

Of course, there was the obligatory reassurance that the doses of butter smell that consumers inhale is highly unlikely to cause lung problems. But butter smell?! What's next?


Blogger teni said...

I wrote a longer comment for yesterday's post that you can read. I just wanted to say hi and that as I continue to read your blog, I'm asking myself why didn't I continue writing? I think my emotional attachment to the first post hinders me to write something to appear above it...

2:30 PM  
Blogger always learning said...

Hi Teni!

I read your comment yesterday, and am glad that you enjoy the ramblings on this page. I think you should write as well - I'm sure there are a lot of great things waiting to be put on your page


10:33 AM  
Blogger Jose said...

This comment has been removed by a blog administrator.

12:17 PM  
Blogger always learning said...

thanks jose.

training will do that - take up too much brain space and make us forget the exciting wonders of the world around us. but the good thing is it's temporary. we can always reawaken that awe and it's beautiful to realize that it never left but was just hidden, waiting for the right time to bloom again...

1:21 PM  
Blogger wandering visitor said...

from jose:

I've always been very suspicious of that butter smell.

I love your posts. As kids destined for medicine, we were attracted to our field in part by a profound fascination with the greater world around us... the grammar structure of whale songs and what it is exactly that makes people happy, and how come you can't keep your eyes open and sneeze at the same time. It's amazing, now as physicians, how little brain space we leave for that kind of thing.

4:55 PM  
Blogger Serjj said...



9:27 AM  

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