Work-related asthma belongs to a category of diseases known as occupational respiratory diseases. According to the World Health Organization, approximately 20 percent of asthma cases in industrialized nations are cases of occupational asthma. Furthermore, the United States Department of Labor estimates that 11 million workers within a wide range of industries and occupations are exposed to at least one of the numerous agents that are associated with work-related asthma.
What Is Work-Related Asthma?
Asthma is a respiratory disease that causes air passages to narrow. Its symptoms include difficult breathing, tightness of the chest, coughing, and wheezing.
Asthma is considered work-related when its cause can be traced back to an agent or condition at work.
Categories of Work-Related Asthma
There are two categories of work-related asthma: occupational asthma and work-exacerbated asthma.
Occupational asthma is caused by specific agents in the workplace. Occupational asthma can be further divided into two groups:
- Sensitizer-induced asthma is caused by sensitivity to an agent. A worker can develop a sensitivity or allergic reaction as a result to continuous or chronic exposure to an agent.
- Irritant-induced asthma, also known as reactive airways dysfunction syndrome (RADS), is caused by one specific, high-level exposure.
- Work-exacerbated asthma occurs in workers who have a history or pre-existing asthma. These workers experience re-occurring asthmatic episodes, which are triggered by exposures to agents while at work
Risk Factors for Developing Work-Related Asthma
A risk factor is something that increases a person's likelihood of developing a condition or disease. The following factors can increase a worker's risk of developing work-related asthma:
- Occupations: bakers, detergent manufacturers, drug manufacturers, farmers, laboratory workers, metal workers, millers, plastic workers, miners, spray painters, and solderers
- Workplace conditions: the presence of agents or allergens coupled with poor ventilation
- Genetics: workers with a family history of asthma or atopy, a syndrome characterized by sensitivity to allergens that predisposes an individual to work-related asthma
- Lifestyle: cigarette smoking
Agents that Cause Work-Related Asthma
There are numerous agents that cause asthma in the workplace. These agents that cause work-related asthma are divided into two groups:
- High-molecular-weight agents: cereals, animal-derived allergens, enzymes, gum, latex, and seafood
- Low-molecular-weight agents: isocyanates, wood dust, dyes, drugs, and metals
Control and Prevention of Work-Related Asthma
There are four main approaches for controlling and preventing work-related asthma:
- Reduce, substitute or eliminate the asthma-provoking agents
- Implement engineering controls, such as ventilation and enclosures for work processes
- Implement administrative controls, such as changing the job task and job rotation, as well as educating workers on proper material handling procedures and good housekeeping
- Use of proper personal protective equipment, such as masks or respirators
Returning to Work with Asthma
Before a worker can return to work, both work and non-work agents of work-related asthma must be identified. Additionally, the worker must be counseled on methods of avoidance.
This preventive approach requires cooperation between the worker and the employer. First, the worker must avoid areas of high irritant exposure and wear adequate respiratory protection. Second, the employer must either eliminate or replace the asthma-provoking agent, or reassign the affected worker to a low-exposure area.
Managing Work-Related Asthma
The first step in managing work-related asthma is obtaining treatment in the form of anti-inflammatory medication. In most workers with asthma, inhaled steroids are the medication of choice.
The second step involves educating the worker about the disease. This is considered an integral part of management.
For the third and final step, the worker should have routine follow-up examinations once the asthma is stabilized.
Work-related asthma is a more serious problem than most people may think. Work-related asthma is costly for everyone. It reduces productivity and quality of life.
Unless occupational asthma is detected and managed early, some employees may become too disabled to work, while others may be forced to change jobs to avoid the asthma-provoking agents (for more on how air quality can affect your work, see How to Understand Air Pollution and be Prepared for High Risk Days).
Together, employers and employees can create safe worksites that minimize exposure to allergens and irritants, reducing the impact of work-related asthma on health and productivity.