Occupational lung diseases are under-recognized by most general (and respiratory) physicians. When affected individuals are of working age, the diagnosis can result in significant socio-economic consequences. A comprehensive knowledge of all occupational lung diseases is beyond the remit of most respiratory physicians, but an understanding of the relationships between work and disease is crucial to ensure that cases are not missed. This chapter presents two contrasting cases. The first is a ‘traditional’ case of occupational asthma, the most commonly reported occupational lung disease in the United Kingdom (as well as in most ‘developed world’ countries). The second case describes a rare disease (obliterative bronchiolitis) recently linked to a few select work exposures, highlighting the complexity of establishing causation in suspected occupational disease, particularly one uncommon in the general population. An occupational history should be taken in all cases of respiratory disease; access to specialist advice is freely available and frequently invaluable.
