Summary about Disease
Work-related asthma is asthma that is caused or worsened by exposures in the workplace. It can be either:
Occupational asthma: Asthma caused by inhaling dusts, gases, fumes, or other substances while on the job in a person who did not previously have asthma.
Work-exacerbated asthma: Pre-existing asthma that is made worse by conditions in the workplace.
Symptoms
Symptoms of work-related asthma are similar to those of general asthma and may include:
Wheezing
Coughing
Shortness of breath
Chest tightness
Runny nose
Nasal congestion
Eye irritation These symptoms are often worse at work and may improve when away from work (e.g., on weekends or holidays).
Causes
Work-related asthma can be caused by a variety of substances found in different workplaces. These substances, known as sensitizers or irritants, can include:
Chemicals (e.g., isocyanates, anhydrides, metals, wood dust, cleaning agents)
Animal allergens
Plant allergens
Fungi
Gases and fumes
Dusts (e.g., grain dust, textile dust, metal dust)
Latex
Irritants (e.g., chlorine, sulfur dioxide) Numerous industries have exposure to these substances, including the manufacturing, agriculture, healthcare, and construction industries.
Medicine Used
The medications used to treat work-related asthma are the same as those used for general asthma and may include:
Inhaled corticosteroids: To reduce inflammation in the airways.
Long-acting beta-agonists (LABAs): To open the airways for a longer period.
Short-acting beta-agonists (SABAs): For quick relief of symptoms (rescue inhalers).
Combination inhalers: Containing both an inhaled corticosteroid and a LABA.
Leukotriene modifiers: To reduce inflammation and mucus production.
Theophylline: A bronchodilator.
Biologic therapies: Omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab
Oral corticosteroids: For severe exacerbations.
Is Communicable
Work-related asthma is not communicable. It is caused by individual exposure to substances in the workplace and cannot be spread from person to person.
Precautions
Preventing work-related asthma involves minimizing exposure to causative agents in the workplace:
Engineering controls: Ventilation, enclosure of processes, substitution of less hazardous materials.
Administrative controls: Work practices to minimize exposure, employee training, regular monitoring.
Personal protective equipment (PPE): Respirators, gloves, eye protection.
Early detection and management: Regular medical surveillance, prompt evaluation of symptoms.
Smoking cessation: Smoking can worsen asthma symptoms.
Avoidance: If possible, individuals diagnosed with work-related asthma should avoid further exposure to the causative agent.
How long does an outbreak last?
Work-related asthma doesn't occur in "outbreaks" in the same way that infectious diseases do. However, if there's a new exposure in the workplace (e.g., a new chemical introduced), a cluster of new cases might appear over weeks or months. The duration of symptoms for an individual depends on several factors, including the severity of the asthma, the length and intensity of exposure, and how quickly the individual is diagnosed and treated. Symptoms can persist long-term if exposure continues or if lung damage has occurred.
How is it diagnosed?
Diagnosis typically involves:
Medical history: Detailed assessment of symptoms, work history, and potential exposures.
Physical examination: Listening to the lungs for wheezing.
Pulmonary function tests: Spirometry (measures how much air you can inhale, exhale, and how quickly you can exhale) and methacholine challenge test.
Allergy testing: Skin prick tests or blood tests to identify potential allergens.
Bronchial provocation testing: Controlled exposure to suspected workplace substances under medical supervision (performed in specialized centers).
Peak expiratory flow (PEF) monitoring: Measuring PEF at work and away from work to identify work-related variations.
Timeline of Symptoms
The timeline of symptoms can vary:
Sensitization period: May take weeks, months, or even years of exposure before symptoms develop.
Initial symptoms: Often mild and intermittent, worsening with continued exposure.
Progression: If exposure continues, symptoms become more frequent and severe, even at lower levels of exposure.
Long-term: After exposure ceases, symptoms may improve, but some individuals may have persistent asthma symptoms and require ongoing treatment.
Important Considerations
Early diagnosis and intervention are crucial to prevent irreversible lung damage.
Accurate identification of the causative agent is essential for effective prevention and management.
Workers' compensation may be available for individuals with work-related asthma.
Workplace assessment and modification may be necessary to prevent further exposure.
Collaboration between healthcare providers, employers, and employees is important for successful management of work-related asthma.