Author Archives: Jackie Aim

Investigations and tests

The main investigation for occupational asthma is your peak flow diary. You should do at least 4 peak flow tests spread throughout the day when you are at work and when you get home. The diary is kept for at least 3 consecutive days. It can be repeated when you are away from work on consecutive days to check for differences.

Some people with asthma may be given an Immunoglobulin E (Ig E) blood test which may show sensitivity to large dust particles.

Other lung function tests can be done in specialist hospitals. However, they will not always show a reaction even if you have a sensitivity to a work place irritant.

Sometimes a skin prick test is done for allergic reactions but many of the industrial causes for asthma cannot be tested using the skin prick method.

Recognising and diagnosing occupational asthma

Often, there are symptom patterns and signs characteristic of occupational asthma when there is no other explanation for these symptoms.

Likelihood of diagnosis increases if symptoms include two or more of these are mentioned:
icon_bronchial_sq icon_tightChest_sq Cough Breathless Peak expiratory flow meter
Wheezing or wheezy sounds in your chest. Chest tightness. Cough. Shortness of breath. Low forced expiratory flow in 1 second (FEV1) or reduced peak flow rate (British guidelines on management of asthma).

Symptoms of occupational or work aggravated asthma

Man blowing nose

Conjunctivitis

Symptoms worsen while at work and improve or disappear when away from work.

Symptoms may also improve with inhaler treatment, but can improve without medication if irritant exposure is reduced.

Other symptoms:

  • Rhinitis (inflammation inside nose causing sneezing, blocked, itchy and running nose).
  • Conjunctivitis (often called Pink Eye, an infection between outer lining of eye and eyelid).

Occupational asthma FAQs

You have to use flour at the bakery where you work. What protective clothing should you wear? Click to show

Face mask, overall, gloves, hair net. This will not totally protect you but it will reduce risk of exposure.

Is your employer responsible for checking and controlling substances which trigger your asthma? Click to show

Yes, the legal health regulations for this are known as COSHH Control of Substances Hazardous to Health. Your employer should carry out a risk assessment and prevent or control exposure to irritants. Find out more at the Health and Safety Executive website.

You had asthma as a child but nothing for years but recently your symptoms have returned. Could something at work be making your asthma flare up again?Click to show

Possibly. This is known as work aggravated asthma. If there is a specific irritant only present at work you may have Reactive Airway Dysfunction Syndrome or RADS.

My boss isn’t taking my asthma seriously. What can I do?Click to show

Discuss with your GP. They should be able to give you a letter which outlines how your asthma can be affected by your work and the precautions you and they can take. If you have an occupational health nurse you could speak to them or a union representative.

Health and Safety Executive

The Health and Safety Executive is an independent watchdog for work-related health, safety and illness. Their website has a section about asthma at work which gives lists of occupations and irritants at work. It also gives information for you and your workplace about occupational asthma and work related asthma. There is also an asthma quiz to find out what you know about asthma at work.

Allergens and irritants are classified in high or low molecular weight, depending on their size.

  • High molecular weight means big molecules and include animal dander and plant pollens.
  • Low molecular weight means small molecules and include mostly chemicals used in lots of manufacturing and pharmaceutical industries and are the leading causes of occupational asthma.

Occupations and common irritants

Occupations which may trigger asthma include:

Spray painter Baker Healthcare worker Chemical worker
Spray painter Baker Healthcare worker Chemical worker
The isocyanides in spray paint may be a trigger. The flour and grain dust in a bakery may trigger asthma. Cleaning products and latex may be a trigger for asthma. Chemicals (anhydrides) in the plastic and drug industries are a potential trigger for asthma, as are antibiotics.
Animal handler Food processor Welder Timber worker
Animal handler Food processor Welder Timber worker
Animal dander (microscopic skin, fur and saliva) may be a irritant for asthma. Food additives and colourings may also be a trigger. Welding fumes can be an asthma trigger. Wood dust may be an asthma irritant.

This list is not exhaustive and other jobs may trigger asthma.

Reducing your risk

pollen

Pollen

Protective clothing

Protective clothing

Pack of cigarettes and smoke

Smoking

    Exposure level at work can determine your risk of developing occupational asthma. To reduce your risk try:

  • removing or reducing exposure to anything causing irritation.
  • Avoiding any known allergies.
  • To avoid smoking or being in areas where others are smoking.
  • Seeking advice from occupational health or Health and Safety Executive.
  • Using protective clothing or equipment.

Occupational vs. work aggravated asthma

Select the pictures to see some occupational versus work aggravated asthma examples:

Occupational asthma

Work aggravated asthma

View text alternativeClick to show

Occupational
Delayed allergic Susan is a hairdresser who has been working for three years. Her asthma has gradually got worse. She has been using many different hair dyes and this is the cause of her delayed reaction. She is now thinking of changing her job or asking her boss if she can avoid doing hair dying in future.
Immediate
Non allergic Reactive Airways Dysfunction Syndrome (RADS)		 John is training as an apprentice plumber. His asthma has flared up since he started three months ago. This is partly due to the amount of extra physical work he is now doing and partly due to the symptoms associated with Reactive Airways Dysfunction Syndrome (RADS).
RADS:

  • Occurs on exposure to trigger
  • Immediate onset of symptoms after one exposure, peaking after a few hours
  • No symptoms documented prior to respiratory complaint
  • Persistent symptoms for 3 months ( cough, wheeze +/-breathlessness)
  • Airflow obstruction on breathing test
  • Non- specific bronchial hyper-responsiveness
  • No other breathing related diseases.
Work aggravated
Pre existing asthma + work aggravated Mark had asthma as a child but he has had no asthma attacks since he was a teenager. He started working in a food processing factory a few weeks ago and suddenly his asthma symptoms have returned. After seeing his GP and following some tests at the local hospital he has found out that he is hyper sensitive to some of the food colourings used at work. He may have to change jobs within the factory to avoid contacts with the food colourings.
Pre existing asthma + work aggravated + occupational asthma Jane is working as a part time nurse. She has had asthma since childhood and she has been successfully managing her asthma. Recently she changed her job on the same ward from part time to full time work. This involves 12 hour shifts which are more physically demanding. At the same time a new antibacterial cleaner is being used on the ward. A combination of the’ new cleaning materials used on the ward and the increased effort required in her new shift pattern has triggered the worsening of her previously well controlled asthma. After seeing her GP she is referred to the occupational health department in the hospital. They work with her respiratory team to find a solution to Jane’s working environment, symptoms and treatment.