By Healthesystems
In July 2026, smoke from more than 800 wildfires burning across Canada wafted to the United States, placing millions of Americans under air quality alerts. This is just one example of the increased wildfire activity that is bringing greater attention to occupational lung diseases, particularly among firefighters. Though these diseases still make up a small portion of workers’ comp claims, they can incur significant costs as they often require life-long monitoring, treatment, and medication.
Due to the sheer variety of chronic lung diseases, the medications used to treat them are diverse. Here’s are five important considerations for the pharmacy management of lung conditions in workers’ comp:
#1. Long-Duration Therapy and Cumulative Cost Exposure
Because many occupational lung diseases are life-long conditions – with exceptions like occupational asthma, which can improve after exposure removal – patients may require long-term medications, often having to switch or combine medications over the course of a claim. This requires effective drug monitoring and can incur significant costs over time.
#2. Episodic Escalation, Flare-Ups, and Secondary Concerns
At times, the symptoms of occupational lung diseases can worsen, flare up, or be exacerbated by other conditions. This can result in the need for additional medications (such as short-acting bronchodilators or oral corticosteroids) in addition to long-term medications.
Occupational lung diseases can also be exacerbated by infections, a buildup of mucus, and gastroesophageal reflux diseases (GERD) – requiring the prescription of various antibiotics, mucus thinners, or GERD agents. Each of these medication classes not only incur additional costs, but they add additional elements of complexity within pharmacy management.
#3. Complex Safety Profiles
The medications used to treat occupational lung diseases come with various safety considerations, especially as patients may be taking several of these drugs at a time. To promote safe and effective therapy, pharmacy management requires a deep understanding of these medications and their potential risks. Examples include gastrointestinal effects associated with antifibrotics, immunosuppressants, and leukotriene modifiers; liver concerns with antifibrotics and PDE4 inhibitors; and hematological issues with immunosuppressants.
#4. Specialty/Oncology Considerations
Cancer therapies are constantly evolving, and the newer, more effective, and least toxic drugs tend to come with the highest price tags. Many of these newer drugs are becoming part of the standard of care. This means that while cancer survival rates are higher than ever – cancer deaths have decreased by 33% over the last 30 years, according to the American Cancer Society – the cost of cancer care continues to rise as new drugs enter the market.
#5. Drug Adherence Considerations
Given the complexity and long-term nature of occupational lung diseases, drug adherence is a significant factor in providing optimal care. While these claims often demand specialized expertise, additional healthcare professionals can also play a supportive role. For example, connecting patients with a clinical pharmacist can support medication adherence and advise patients on managing side effects.
Additionally, when it comes to various inhaler-based medications, patient understanding of how to use these medications can impact their effectiveness. For example, as many as 70-80% of people with asthma are unable to use their inhaler devices correctly, according to one review – making it important to evaluate if patients understand safe and effective techniques for this type of treatment.
Want to Learn More?
To learn more about occupational lung diseases in workers’ comp, including the different types of occupational lung conditions, read our RxInformer magazine article, Deep Breath: Occupational Lung Diseases and Pharmacy Management.
