RESPIRATORY DISORDERS

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RESPIRATORY DISORDERS

• Physical Disabilities, Rehabilitation and
  Employment
• BCE 542
• September 17, 2002

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The Lungs

• Sacks consisting of tubes or branches which
  become progressively smaller as one moves from
  the trachea (windpipe) deeper into the lungs.
• The tubes (bronchioles) terminate in clusters of
  small sacks called alveoli.
• In these sacks the blood picks up oxygen from
  the lungs.

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Lung Problems

• Irritation
• Blockages
• Congestion
• Particles
• (Infection)
• (Cancers)

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Chronic Obstructive Pulmonary Disease (COPD)

• The end result of chronic lung irritation or
  chronic lung diseases.
• Consists of two diseases
• Chronic Bronchitis
• Emphysema

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Chronic Bronchitis

• Constant irritation of bronchial tubes of the
  lungs causes lungs to be congested with mucous.
• Can be caused by smoking, exposure to atmospheric
  irritants, other lung diseases (asthma, cystic
  fibrosis)
• Individual is susceptible to respiratory
  infections.
• Develops unsightly cough to clear air passages of
  phlegm blood may not carry adequate oxygen
  (blue bloaters)

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Emphysema

• Inability to Exhale
• Develops as a consequence of long-term chronic
  bronchitis.
• Clusters of alveoli merge into one air sac as
  the lungs have to work harder in chronic
  bronchitis--lose ability to snap back with a
  breath.
• Person is unable to get a good breath lungs
  cannot empty properly.
• Person has shortness of breath (pink puffers)

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Treatment of COPD

• Removal of irritant (once alveoli lose
  elasticity, damage is permanent and
  irreversible).
• Bronchodialators/Nebulizers (Primatine, etc.)
• Care of diet (avoidance of obesity, indigestion)
• Adjustment to lowered physical capacity

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Rehabilitation Considerations

• Avoidance of atmospheric irritants attention to
  climate control
• Avoidance of physical exertion (walking,
  climbing, etc.)
• May need to reconsider person-oriented
  work/persuasive occupations if cough is
  unsightly.
• May need to have flexibility in work schedule due
  to recurring respiratory tract infections
  (absenteeism)
• Age issues.

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Occupational Lung Diseases

• Develop as a result of exposure to irritants in
  the workplace.
• Will eventually lead to COPD or other lung
  diseases if not arrested.
• Two categories
• Pneumoconisis
• Hypersensitivity Pneumonitis

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Pneumoconiosis

• Caused by exposure to inorganic irritants in the
  workplace.
• Black Lung Disease (coal dust)
• Asbestosis (asbestos use and production)
• Silicosis (exposure to silica dust, glass
  industry, tunneling)
• Berylliosis (exposure to beryllium dust
  aerospace industry).
• Aluminosis
• Talcosis

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Hypersensitivity Pneumonitis

• Caused by exposure to organic particles or
  substances.
• Byssinosis (exposure to cotton fibers)
• Fish Meal Lung
• Mushroom Pickers Lung
• Farmers Lung
• Furriers Lung

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Treatment

• Prevention
• Removal from exposure
• May require change in occupation

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Rehabilitation Considerations

• Change of occupation issues.
• COPD issues, esp. in pneumoconiosis.
• Age issues
• Workers Compensation issues

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Bronchial Asthma

• Blockage of bronchial tubes which can be caused
  by allergies, irritants, or other causes.
• Can develop at any age, but most common in
  persons under 40.
• Children with the disorder usually outgrow the
  disease.

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An Asthma Attack

• Pain in chest, difficulty breathing, various
  levels of incapacitiation.
• May last for a few minutes to hours.
• Status Asthmaticus--a prolonged asthma attack
  lasting for days or weeks requires medical
  attention.

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Treatment and Rehabilitation

• Treatment involves removal of irritants,
  bronchodialators.
• Rehabilitation
• Persons are only impaired when the attack is
  occurring.
• Avoid polluted atmospheric environments.
• Physical capacity to perform work will depend
  upon the severity of the disease.

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Cystic Fibrosis (CF)

• A hereditary disorder that primarily affects the
  pancreas however, the involvement of the lungs
  causes it to usually be classified as a
  respiratory disorder.
• Symptoms and Complications
• Severe Digestive Problems
• Stunting of Growth
• Build up of Mucous in the lungs
• Frequent Hospitalization
• COPD, infections develop.
• Death occurs early in life, by mid 20s.

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Treatment

• No cure.
• Antibiotics for infections
• Dietary Restrictions
• Exercises and postural techniques to break up and
  drain mucous.
• Bronchodialators
• Avoidance of heat to prevent loss of body salts.

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Rehabilitation

• Persons with CF are surviving longer and longer
  possible to see some in a rehabilitation
  caseload.
• Flexible home based employment may be a good
  option.
• Often, counseling will be as likely to involve
  parents with children who have CF than persons
  with CF themselves.