What is Occupational Asthma?
“An estimated 11 million workers in a wide range of industries and occupations in the United States are exposed to at least one of the more than 250 substances known or believed to cause occupational asthma.”
– The Occupational Safety and Health Administration.
Occupational asthma, also known as work-related asthma, is a chronic lung disease that is caused or worsened by exposure to substances in the workplace.
There are two types of occupational asthma: one caused by an agent that stimulates the body’s immune system (immune-mediated) and triggers asthma; and another where the agent directly irritates the airways (irritant-induced). Immune-mediated occupational asthma typically occurs with a latency period between the workplace exposure and the beginning of symptoms. This could be few weeks to several years. Irritant-induced occupational asthma, on the other hand, typically occurs immediately after exposure.
What are the Causes?
Triggers of occupational asthma may include chemicals used in manufacturing; paints; cleaning products; dusts from wood, grain, and flour; latex gloves; mold exposure; and/or animals and insects. More specifically, these substances can include:
- Animal substances, such as proteins found in hair, fur, saliva, and bodily waste.
- Chemicals, such as anhydrides, diisocyanates and acids used to make paints, varnishes, adhesives, laminates, and soldering resin. Other examples may include chemicals used to make insulation, packaging materials, and foam mattresses and upholstery.
- Enzymes used in detergents or cleaning products.
- Metals, such as platinum, chromium, and nickel sulfate.
- Plant substances, such as proteins found in natural rubber latex, flour, cereals, cotton, flax, hemp, rye, and wheat.
- Respiratory irritants, such as chlorine gas, sulfur dioxide, and smoke.
Who is at Risk?
Increased risks for developing occupational asthma include individuals with allergies or asthma, a family history of allergies or asthma, and cigarette smokers.
It is possible to develop occupational asthma in almost any work environment. Certain occupations, however, yield high risk in occupational asthma. These include:
- Adhesive handlers
- Animal handlers, veterinarians
- Bakers, millers
- Carpet makers
- Metal workers
- Forest workers, carpenters, cabinet makers
- Hair stylists
- Healthcare workers
- Pharmaceutical workers
- Seafood processors
- Shellac handlers
- Spray painters, insulation installers, plastic and foam industry workers
- Textile workers
What are the Symptoms?
Symptoms of occupational asthma include general symptoms of an asthma attack (i.e. coughing, wheezing, chest tightness, and shortness of breath). Other symptoms such as eye irritation, nasal congestion, and/or a runny nose may also be present.
- Get worse toward the end of the work week and alleviate during weekends and vacations.
- Occur both at work and away from work.
- Start as soon as you’re exposed to an asthma-inducing substance at work or only after a period of regular exposure to the substance.
- Continue after exposure is stopped. The longer you have been exposed to the asthma-causing substance, the more likely you it is will have long-lasting or permanent asthma symptoms.
How is Occupational Asthma Diagnosed?
If you think you have occupational asthma, consult your health care provider about a referral to an asthma specialist. To determine whether your asthma is work-related, a thorough physical examination is required to confirm such a diagnosis. This may include blood tests to look for antibodies to the substance, a bronchial provocation test to measure reaction to the suspected allergen, chest x-ray, completed blood count, peak expiatory flow rate and pulmonary function tests.
Additional information may be requested to accompany your tests. Expect the specialist to take a medical history to review whether any members of your family have allergies, asthma or other allergy-related diseases.
How is Occupational Asthma Treated?
After diagnosis, your specialist may prescribe and recommend treatment and drugs to alleviate the symptoms. Once the irritant is determined, small amounts may trigger asthma symptoms if you become sensitive to the substance. To control your symptoms and prevent asthma attacks, the right medication is prescribed based on your age, symptoms, and triggers.
For long-term control, oral or inhaled medications may include inhaled corticosteroids, leukotriene modifiers, long-acting beta agonists, combination inhalers. For quick-relief, your specialist may recommend allergy medications, allergy shots and/or omalizumab (Xolair) injections.
Schedule a Consultation
Occupational asthma can disrupt everyday life, in and out of the workplace. Understand if you are at risk and consult a specialist to enjoy a more manageable work environment and lifestyle. If you’re a New Yorker and believe you may be suffering from occupational asthma, schedule a consultation with Dr. Shukla today, one of NYC’s premier asthma specialists.