What Is Occupational Asthma?

Occupational asthma is a job-related lung disease in which workplace exposure to certain substances triggers asthmatic episodes, either immediately on contact or after a period of dormancy. Asthmatic episodes occur when air passages in the lungs constrict, making breathing difficult. They can range from mild to severe, even life-threatening. A wide variety of potential workplace substances can serve as triggers, either as natural irritants or as allergens in persons who have become sensitive to them. As many as 15 percent of all American asthma cases may have an occupational origin.

If you experience severe asthma symptoms while on the job, seek medical attention immediately. The emergency department at any Baptist Health medical facility is ready to help you. If your reaction is relatively mild, contact your Baptist Health physician for consultation and treatment.

What Are the Symptoms of Occupational Asthma?

Occupational asthma is one form of asthma and shares with all versions the following symptoms:

• Labored breathing
• Nasal congestion and runny nose
• Red, irritated eyes
• Tearing up
• Coughing and wheezing, sometimes worse at night
• Tightness in the chest

There are also different types of occupational asthma. The primary form is triggered by exposure to a workplace substance. This includes both irritant-induced asthma, which involves high-dose exposures to naturally occurring irritants, and sensitizer-induced asthma, which is the allergy-like sensitivity that sometimes develops after longtime exposure to a workplace substance. Irritant-induced asthma also goes by the name reactive airways dysfunction syndrome (RADS).

A second form of occupational asthma is called work-exacerbated asthma. This describes those situations in which an asthma sufferer experiences the worsening of an already-existing condition while he or she is on the job.

What Causes Occupational Asthma?

The substances behind occupational asthma number in the hundreds. Included are:

• Plant proteins, as found in grains, cereals, and flours
• Animal proteins derived from fur, saliva, hair, dander, scales, and excrement
• A wide variety of industrial chemicals
• Metals, especially chromium, platinum, and nickel sulfate
• Enzymes
• Smoke
• Dust
• Other irritants, especially in aerosol form.

Several risk factors make the onset of occupational asthma more probable. If you or another family member has a history of asthma or allergies, you are a more likely candidate. Smoking and tobacco use also increases the probability of occupational asthma.

How Is Occupational Asthma Diagnosed?

If you’re experiencing possible asthma symptoms, contact your primary care physician. He or she will diagnose your condition, based on family history, a physical exam, and medical test results. Be sure to let him or her know that your symptoms appear work-related; this critical insight will factor into your diagnosis and treatment plan.

Personal & Family History

There is some scientific evidence for asthma having a genetic component. Your physician will want to know if other members of your family have been treated for asthma or allergies. He or she will also want to know about your personal experience with asthma-like symptoms. For example, when do they occur and how often? How severe are they? Are they worse at work than at home? Are they triggered by certain irritants or sensitivities?

Physical Exam

You will also undergo a physical exam. Your physician will look for evidence of asthmatic symptoms. One goal of the exam is to eliminate possible non-asthmatic causes for your symptoms, such as a respiratory ailment or chronic obstructive pulmonary disease (COPD).

Pulmonary Function Tests

Pulmonary function tests measure the volume of air being processed by your lungs when you breathe. There are two primary tests:

• Spirometry estimates the degree of airway constriction that occurs when you breathe. Constricted air passages may indicate asthma.
• Peak flow measures the strength of your out breaths. A low peak-flow reading is typical of asthma. Your physician may ask you to take readings with a small portable device on the job and at home. If they are significantly worse at the worksite, you may have occupational asthma.

Other Medical Tests

Your physician may choose to perform one or more additional tests:

• Imaging tests, including chest X-rays, CT scans, or electrocardiograms (EKGs), to identify respiratory abnormalities or diseases that can affect breathing.
• Allergy skin tests for dust, molds, pollens, dander, latex, and other potential triggers for asthmatic attacks.
• Challenge tests for workplace chemicals that aren’t included in the skin tests. Chemicals are introduced into your system in highly dilute forms by means of an aerosol spray.

How Is Occupational Asthma Treated?

Asthma is controlled rather than cured. Developed in partnership with your physician, a successful asthma action plan will:

• reduce or eliminate major asthmatic symptoms
• strengthen lung function
• lessen the need for quick-relief medications
• let you undertake normal daily activities (including job responsibilities)
• help prevent serious asthma attacks and emergency-room visits

Identifying and avoiding workplace triggers is critical in the treatment of occupational asthma. Also important are the medications selected by your physician for both long-term control of your condition and quick relief when symptoms flare up.

Asthma Control Medications

Long-term control medications are taken daily. Some come in pill form but most are delivered by inhaler. Their primary purpose is to suppress asthmatic symptoms before they occur. Long-term medications include:

• Inhaled corticosteroids
• Leukotriene modifiers
• Long-acting beta-agonists (LABAs)
• Combination inhalers, which combine a LABA with a corticosteroid.

Asthma Relief Medications

Quick-relief medications are only taken when needed. They reverse sudden-onset symptoms by relaxing bronchial muscles and improving airflow in the lungs. Albuterol and other short-acting beta2-agonist medications are designed for quick relief.

How Do I Prevent Occupational Asthma?

The best means of avoiding occupational asthma is avoiding workplace substances that are either irritants or sensitizers. Based on the nature of one’s work, this is sometimes easier said than done.

American workers are protected to some extent by regulations governing the use of hazardous chemicals, as enforced by the Occupational Safety and Health Administration (OSHA). Companies utilizing these chemicals are required to communicate their presence to employees, provide adequate training for handling them, and supply protective gear, including gloves, masks, and respirators. Also required is a record of every hazardous chemical in use, in the form of a material safety data sheet (MSDS). Employees have a right to see these data sheets. The information they contain can be useful to physicians diagnosing an asthma or allergy.

There are also steps you can take to improve your health, even with asthma. Smoking cessation and maintaining a healthy weight can enhance your ability to deal with asthmatic episodes, regardless of cause.

At Baptist Health, Dealing with Asthma Is What We Do

If you suspect that you have occupational asthma, see your Baptist Health primary care physician or allergy specialist. He or she can determine the true nature and extent of your condition, and make recommendations for dealing with it. If your symptoms are severe, call 911 or seek emergency medical care.