Occupational dust exposure and cerebral small vessel disease: a public health perspective on prevention and early detection.

Occupational dust exposure represents a modifiable environmental risk factor not only for respiratory diseases but also for accelerated brain aging through its association with cerebral small vessel disease (CSVD). This link poses a significant yet underrecognized public health challenge for aging workforces in industrial settings. This review synthesizes epidemiological and mechanistic evidence supporting the "lung-brain axis"-a proposed pathway through which dust inhalation may contribute to systemic inflammation, blood-brain barrier disruption, and subsequent CSVD pathology. We critically evaluate the central role of multimodal neuroimaging [including advanced Magnetic resonance imaging (MRI) and retinal imaging] in detecting and quantifying these cerebrovascular changes. Furthermore, we highlight the transformative potential of artificial intelligence (AI) in integrating multi-source data for risk prediction and enabling early intervention. This synthesis aims to highlight an emerging occupational health threat and to propose a scalable framework for surveillance and prevention to protect brain health in exposed worker populations. Most available evidence is cross-sectional; prospective studies are needed to establish causality.