BIOMARKERS IN OCCUPATIONAL LUNG DISEASES: ADVANCES AND FUTURE DIRECTIONS

Background: Occupational lung diseases (OLDs) remain a major global health concern, arising from chronic exposure to hazardous airborne agents such as mineral dusts, fumes, and chemical vapors. Early detection is essential to prevent irreversible damage, yet conventional diagnostic methods often identify disease only after substantial structural changes have occurred. Biomarkers offer an opportunity for earlier recognition of exposure, effect, and individual susceptibility. Objective: To review and summarize recent advances in biomarkers relevant to the early detection, monitoring, and risk stratification of occupational lung diseases. Methods: A narrative review of published literature was conducted, focusing on biomarkers associated with classical pneumoconioses, chronic granulomatous disorders, and occupational airway diseases. Emphasis was placed on inflammatory markers, cytokine signatures, susceptibility indicators, and disease-specific markers in asbestosis and silicosis. Results: Multiple classes of biomarkers—including oxidative stress markers, pneumoproteins, cytokines, acute-phase reactants, and transition metals in exhaled breath condensate—demonstrate strong potential for early detection of occupational respiratory injury. Disease-specific biomarkers such as soluble mesothelin-related peptide (SMRP), osteopontin, and 8-oxo-dGuo show promise in asbestos-related disorders, while elevated TNF-α, IL-1β, IL-6, IL-8, serum ACE dysregulation serve as key indicators in silicosis. Combined biomarker panels improve diagnostic accuracy and may allow earlier recognition of disease before radiologic changes appear. Conclusion: Biomarkers represent a critical advancement in the prevention and early detection of occupational lung diseases. Integrating exposure, effect, and susceptibility markers can enhance clinical decision-making, facilitate timely interventions, and support precision medicine approaches in occupational respiratory health. Future research should prioritize standardization, validation, and multi-marker profiling to enable routine clinical application.