Occupational Asthma
Workplace-related asthma triggers and management considerations.
Overview
Occupational asthma is asthma that is caused or worsened by exposure to substances in the workplace. It's one of the most common work-related lung diseases and can develop in individuals with or without a history of asthma.
types
work Aggravated
Pre-existing asthma that is worsened by workplace exposures
work Induced
New-onset asthma caused by workplace exposures (also called sensitizer-induced occupational asthma)
common Triggers
- Isocyanates (paint, foam, adhesives)
- Flour and grain dust
- Wood dust
- Animal dander and proteins
- Latex
- Cleaning agents and disinfectants
- Metal salts (platinum, nickel, chromium)
- Formaldehyde
- Dyes and resins
- Enzymes (detergents, pharmaceuticals)
symptoms
- Wheezing
- Shortness of breath
- Chest tightness
- Coughing
- Symptoms that improve on weekends or vacations
- Symptoms that worsen during work shifts
- Symptoms may develop immediately or after several hours of exposure
evaluation
history
- Detailed work history including job duties and exposures
- Timing of symptoms in relation to work
- Improvement away from work
- Onset of symptoms after starting new job or change in workplace
- Co-workers with similar symptoms
testing
- Spirometry before and after work shift
- Peak flow monitoring at work and away from work
- Specific inhalation challenge testing (in specialized centers)
- Skin prick testing for occupational allergens
- Serum IgE testing for specific occupational allergens
documentation
Thorough documentation is essential for workers' compensation claims and workplace accommodations
management
immediate
- Remove from exposure if possible
- Use appropriate personal protective equipment (PPE)
- Optimize asthma control with medications
- Consider workplace accommodations
long Term
- Complete removal from exposure (most effective)
- Engineering controls to reduce exposure
- Administrative controls (job rotation, reduced exposure time)
- Personal protective equipment as last resort
- Regular monitoring of lung function
referral
- Refer to occupational medicine specialist for comprehensive evaluation
- Consider referral to pulmonologist for specialized testing
- Workers' compensation evaluation may be needed
- Documentation for workplace accommodations or disability claims
prevention
- Proper workplace ventilation
- Substitution of less hazardous materials when possible
- Worker education about hazards
- Pre-employment screening for at-risk individuals
- Regular health surveillance for exposed workers
prognosis
Early identification and removal from exposure offers the best prognosis. Continued exposure can lead to permanent lung damage and persistent asthma even after removal from the workplace.
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