New technologies are introducing new threats to the respiratory health of workers. This is highlighted in a study published last January by http://thelancet.com/journals/lanres/article/PIIS2213-2600(16)30424-6/fulltext" The Lancet. This is the existing most updated review of this kind of exposure of workers to the elements that can cause respiratory diseases. Dr Xavier Muñoz, Assistant at the http://www.vhebron.net/en/pneumologia Pneumology Service at Vall d'Hebron and researcher of http://en.vhir.org/portal1/grup-equip2.asp?s=recerca&contentid=187035&t=Pneumologia Pneumology goup of Vall d'Hebron Research Institute (VHIR) is one of the authors of the study and the only one from a centre of the country.The article points out that, even though the causes and the ways to avoid many of the pulmonary diseases with origins in the work place are known, in many areas of the world the occupational exposure is still causing a high number of deaths. Especially in countries experiencing a rapid economic growth, where control measures have not been implemented to prevent forms of exposure. A phenomenon that is accentuated with the implementation of new technologies that adds new threats to the workplaces.The authors have worked for a year and a half to identify known routes of exposure to elements that can cause respiratory diseases in the workplace, but also new forms of exposure. One of the most common is asbestos present in construction materials, now banned in the European Union but which is still used in many countries. There are still 125 million people worldwide exposed to this element. Another is the silica, the main cause of occupational respiratory diseases due to the non-conventional routes of exposure. One of them is their presence in the building materials that are used as a replacement of marble in kitchens and toilets.New routes of exposureOne of the highlights of the study and that makes it "a review of reference", according to Dr. Muñoz, is the analysis of the new forms of exposure to chemical agents or inorganic material. This is the case of the workers in charge of the discoloration of the fabric to make jeans. To do this a jet of sand is used, causing volatile particles that may end up in the lungs of the person handling the material, causing severe silicosis and lung function impairment after brief exposures. Despite the prohibition of this technique in many countries, is still used in China, Bangladesh and Pakistan.The technique of hydraulic fracturing to extract oil and gas from the ground can also cause respiratory problems for operators. The pressure injection of material can expose them, and the people who live near the exploitations, to silica, organic elements and other products that can cause a range of respiratory problems such as asthma, chronic obstructive pulmonary disease (COPD) and lung cancer.The manufacture of liquid crystal displays is also one of the important new routes of exposure. In this process indium oxide is used, a product that in 2003 was linked for the first time in a case of interstitial pneumonitis in Japan. Another group of workers exposed to elements that can cause respiratory diseases is that of those in charge of the manufacture of corn popcorn. In 2000, eight cases of bronchiolitis obliterans were diagnosed in the state of Missouri, United States. The culprit, a product used as a condiment, the diacetyl. Measures to reduce exposure to this element have already been implemented, which is also used in other industries of the food industry.It has also been found that exposure to nanoparticles and chemical products, such as volatile organic compounds generated during the combustion of petroleum products, can cause respiratory problems. This is the case of vendors that fill lighters on the streets of India or of the people who work in petrol stations.Prevention strategiesFor Dr. Muñoz, prevention strategies have gain importance considering these new threats. They are divided into three: primary, secondary and tertiary. In the case of the primary strategies, they help to reduce the incidence of the disease, they are the responsibility of hygienists and are required to be well-documented on the possible chemicals agents or find alternatives and measures to reduce workers' exposure to these elements.The secondary strategies allow to decrease the progression of the disease and its severity through surveillance devices. In this field, "there's a lot of discussion about how to implement them", he explains. The tertiary, such as early diagnosis, are applied to detect the disease, and serve to reduce the complications and consequences.Lung diseasesAccording to estimates by the International Labour Organisation, each year two million workers die from accidents or illness out of a population of 2.5 billion. One third of those killed by disease, suffered from lung cancer or the so-called interstitial pulmonary disease. In Catalonia and in the country, there is no verified data, since they are not notifiable diseases to health authorities.Several estimates point at more than 300 cases of occupational respiratory disease that can be declared in a year in Catalonia, half of them occupational asthma. In fact, the workplace is the cause of 1 out of every 4 cases of asthma presented in adulthood. However, Dr. Xavier Muñoz ensures that these pathologies "very underdiagnosed, the situation in this field is deplorable."Vall d'Hebron Barcelona Hospital CampusThe Vall d'Hebron Campus consists of the Vall d'Hebron University Hospital, Vall d'Hebron Research Institute (VHIR), the Vall d'Hebron Institut of Oncology (VHIO) and the Centre for Multiple Sclerosis of Catalonia (Cemcat) The new project represents a new way of working and doing, where research, teaching and clinical practice go together, in the same direction, to join efforts and to grow, being more useful, more productive and more effective.