What everyone should know about asthma at work

Facts | 6/29/2022
What everyone should know about asthma at work
Exposures in the workplace can cause allergies and trigger asthma. Even a single high-dose exposure to chemicals can cause a syndrome called irritant-induced asthma.

Work-induced asthma is a type of asthma caused by exposure to irritants in the workplace. It falls under the broader category of “work-related asthma”, which also includes “work-exacerbated asthma”, a condition describing people who suffer a worsening of their asthma symptoms while at work.

“Work-related asthma is a tricky concept. I prefer to make a clear distinction between work-induced asthma and work-exacerbated asthma,” says respiratory specialist Irmeli Lindström, Chief Physician at the Finnish Institute of Occupational Health.

Asthma is a complex disease caused by many different factors, including a genetic component. There is usually no single identifiable cause of adult-onset asthma.

“Roughly one in five asthma patients experience aggravation of their existing symptoms while at work,” describes Lindström.

Approximately 80 new cases of occupational asthma are diagnosed annually in Finland. Lindström points out that this is just the tip of the iceberg, but every confirmed diagnosis is helpful in identifying risks.

Asthma can result from progressive sensitization to a substance, but it can also be caused by a specific, massive exposure, sometimes as the result of an industrial accident.

“Airway damage can occur even after a single acute exposure to irritant or corrosive chemicals. This type of asthma is called irritant-induced occupational asthma,” Lindström explains.


Risks lurk in unexpected places

Risks are present in many workplaces. Lindström reveals that farm workers account for one third of all occupational asthma cases reported to the Finnish Institute of Occupational Health.

“Cows are the leading cause of asthma among dairy farmers, who typically develop an immediate reaction caused by an allergen-specific immunoglobulin E (IgE). Other allergy risks for farmers include animal feed and grain storage mites. High-level exposure to ammonia during sludge treatment presents an additional risk of irritant-induced asthma.”  

Bakers and food industry workers who inhale flour dust are likewise at risk for asthma, while chemicals are the leading cause of work-related asthma in beauty salons and many industrial jobs. Lindström adds that occupational asthma is also present in education, social and healthcare professions.

“These cases are primarily associated with exposure to water damage, and their incidence has luckily declined in recent years.”

Greenhouse workers are a new group with a high prevalence of asthma. “Plants, mites and insects are typical sensitizers. Workers can for instance become sensitized to the insects used for pest biocontrol, which can eventually trigger asthma,” Lindström describes.


Priority one: minimize exposure

To prevent damage to health, workplace conditions and work stages must be planned carefully.

“The best precaution is to minimize exposure to allergens. In large bakeries, dough is usually handled in a closed system. Ventilation control could also be introduced in greenhouses to minimize dust exposure during plant-handling, and workers can of course protect themselves by wearing respirators.”

The onset of asthma can be prevented by early risk detection. If a worker is exposed to allergens in the workplace and suffers from frequent rhinitis, wheezing or shortness of breath during physical activity, their symptoms must be taken seriously – especially if the symptoms subside during periods off work.

Lindström points out that asthma is not reversible – once the symptoms appear, the disease will not go away. “It can be triggered by even the slightest exposure. Sometimes it’s impossible to fully prevent all exposures in the workplace, in which case the patient might have to undergo retraining.”

Childhood asthmatics should consider these health risks before choosing their future occupation, but Lindström emphasizes that much depends on the severity of their condition. Guidance should be given to young asthmatics to help them assess their safest career options.

“We mustn’t add to their problems with excessive restrictions. These days most asthmatics suffer only mildly. With proper precautions, asthmatics can cope well in all sorts of jobs without any problems.”

 
5 steps to a lung-friendlier workplace

  1. Minimize exposure
    If allergens are present in the workplace, every precaution must be taken to minimize exposure by means of careful work planning, proper ventilation and fume extraction, chemical and dust monitoring, and use of respirators and other protective equipment during risky work procedures.
  1. Identify high-dose situations
    Emptying a sack of flour can result in acute, high-level exposure to flour dust. High-dose exposure can be a significant asthma trigger.
  1. Improve work processes
    Technology has improved safety even in high-risk jobs. Machines and efficient filters can for instance help farm workers perform many tasks safely.
  1. Clear instructions
    High-dose exposure can occur even during simple work routines. Explicit instructions can prevent situations where workers make dangerous mistakes such as mishandling industrial chemicals or cleaning a hazardous spill with a pressure washer. If workers in high-risk jobs develop work-related rhinitis or asthma symptoms, they should seek occupational health care without delay.
  1. Invest in proper respirators
    Workers can keep themselves safe from dangerous fumes and dust by wearing either a valved, filtering half mask or a powered air-purifying respirator. Modern respirators are advanced and easy to use, but they can still slow down certain processes by impeding communication.


Text by Johanna Paasikangas
Photo by iStock

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