Understanding Occupational Asthma

Overview

Approximately 10 to 25 percent of adults with asthma experience occupational asthma. Occupational asthma is a type of asthma caused by irritant exposure in the workplace. Occupational lung disease is often reversible, which means symptoms may resolve when the irritants that caused the asthma are avoided. However, permanent damage can result if the person experiences prolonged exposure.

Like other types of asthma, occupational asthma can cause coughing, chest tightness, wheezing and shortness of breath. People with allergies or with a family history of allergies are more likely to develop occupational asthma.

Causes of Occupational Asthma

There are over 300 chemicals in the workplace that can cause occupational asthma. Because this list is growing it is important to find the causes of work-related asthma so that it can be prevented. The auto parts, foam, and plastic manufacturing industries have the highest rates of work-related asthma. One of the main groups of chemicals that cause occupational asthma is isocyanates. This is a highly reactive chemical that is mainly present in the automobile industry for the production of foam, automotive body parts and paint.

Other substances that may cause asthma in the workplace include:

  • Animal substances, such as proteins found in dander, hair, scales, fur and body waste.
  • Chemicals used to make paints, varnishes, adhesives, laminates, and soldering resin. Other examples include chemicals used to make insulation, packaging materials, and foam mattresses and upholstery.
  • Enzymes used in detergents and flour conditioners.
  • Metals, particularly platinum, chromium, and nickel sulfate.
  • Plant substances, including proteins found in natural rubber latex, flour, cereals, cotton, flax, hemp, rye, wheat, and papain – a digestive enzyme derived from papaya.
  • Respiratory irritants, such as chlorine gas, sulfur dioxide, and smoke.

Types of Occupational Asthma

Allergic Occupational asthma

A common form of asthma can result from workers being exposed to an allergic substance (allergen) over a sustained period of time. It usually takes months to years for the body to become sensitized to an allergen but once this has happened even the smallest exposure can trigger an asthma attack. The most common substances causing allergic occupational asthma are flour dust and amylase (a bakery enzyme) and isocyanates.

Irritant-Induced Occupational Asthma

A non-allergic type of asthma, which can occur when a worker breathes in an irritant substance like a chemical. It can happen when there is an accidental chemical spillage of, for example, chlorine or ammonia.

Occupational Asthma Treatment

The best way to treat occupational asthma is to identify the substance that your suspect is causing your symptoms and then try to avoid contact with it until you have more information either from your medical provider or company occupational health team. Diagnosis does not necessarily mean giving up your job, but sometimes moving to another area of the business is the best solution.

Treatments are the same as for other types of asthma, like drugs that open the airways (bronchodilators), preferably in an inhaler (for example, albuterol). Also, drugs that reduce inflammation, either in an inhaler (for example, the corticosteroid triamcinolone) or as a tablet (for example, montelukast). For severe attacks, corticosteroids such as prednisone may be taken by mouth for a short time. For long-term management, corticosteroid inhalation is the best choice over oral corticosteroids.

Occupational Asthma Diagnosis

The diagnosis of occupational asthma requires detailed documentation of exposure to irritants or allergens in the workplace and evidence that these substances are causing symptoms. In a test called a specific inhalation challenge, you are exposed to a small amount of a possible workplace irritant or allergen. Lung function is then measured to find out whether the substance is the cause of symptoms.

Occupational Asthma Prevention

Avoidance of triggers is the best prevention against asthma. If occupational asthma symptoms do occur, you may need to change jobs to avoid exposure. However, certain steps taken in the workplace can help reduce the risk of occupational asthma:

  • Change the work process to handle irritant exposure more effectively.
  • Use industrial hygiene techniques that are suitable for the type of irritant to which you are exposed and will minimize exposure levels.
  • Have regular medical checkups to determine possible damage to the lungs or other specifically irritant-related medical conditions.
  • Be aware of any personal and/or family medical history of asthma that may put you at greater risk of occupational asthma in certain industries.

When to See a Doctor

Seek immediate medical treatment if your symptoms worsen, as severe asthma attacks can be life-threatening. Make an appointment to see a doctor if you have breathing problems, such as coughing, wheezing or shortness of breath. Breathing problems may be a sign of asthma, especially if symptoms seem to be getting worse over time or appear to be aggravated by specific triggers or irritants.

An allergist/immunologist, like Dr. Amy Schiffman, is the best-qualified physician in Boca Raton to determine if your symptoms are allergy or asthma-related. Dr. Schiffman can properly diagnose the problem and develop a treatment plan to help you feel better and live better. To request an appointment, call her at 561-409-2800.

Please call the office to discuss your allergy evaluation needs, and medications to avoid in preparation for testing.

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