Occupational Asthma

What is occupational asthma?

Occupational asthma is a type of asthma that happens when substances that you breathe in at work inflame and irritate your airways. It can cause asthma attacks that make it hard to breathe. Substances that can cause occupational asthma include dust, chemicals and molds.

You might develop occupational asthma right away after breathing in these substances. Or it can take a long time to develop symptoms.

Types of work-related asthma

There are two kinds of asthma related to work:

• Occupational asthma is when someone who never had breathing problems before develops asthma symptoms from inhaling (breathing in) substances at work.
• Work-exacerbated asthma is when existing asthma gets worse from exposure to substances at work.

What are the symptoms of occupational asthma?

Symptoms of occupational asthma are the same as symptoms caused by other types of asthma, including:

• Shortness of breath
• Wheezing
• Chest tightness, pain or pressure
• Coughing

What causes occupational asthma?

A reaction to substances you’re exposed to at work causes occupational asthma. Inhaling certain things causes your airways to swell and makes it hard to breathe.

Occupational asthma can happen from irritation (sometimes called reactive airways dysfunction syndrome) or an allergic reaction, where your immune system causes inflammation to try to remove something it thinks is harmful. Many different types of substances can cause this reaction. It sometimes takes a long time before it develops.

Can dust cause asthma?

Yes, dust is a common lung irritant that triggers asthma. In fact, more than 300 known substances can cause or worsen asthma. Some occupational asthma triggers include:

• Animal dander, hair or feathers
• Building materials, like insulation, carpeting and foam
• Chemicals like glues, coatings, dyes or plastics
• Paints, varnishes and spray on polyurethane products
• Latex
• Flour or grain dust
• Wood dust

Note that you may develop occupational asthma even if you use a respirator or personal protective equipment.

Which jobs put you at higher risk for occupational asthma?

You can develop occupational asthma from any job that exposes you to lung irritants. You might be at a higher risk if you work:

• As a baker, farmer, grain elevator worker or miller
• In healthcare
• In pharmaceuticals, with exposure to airborne drug particles
• With animals
• With cleaning products
• With metals, plastics or wood
• With automotive paints and sprays

How do I know if my job is causing asthma?

Signs of occupational asthma tend to get better when you’re away from work for a while. If you notice your symptoms get better when you go on vacation or take a weekend off, they may be happening because of workplace irritants.

The symptoms might not get better soon after leaving work. It may take a few weeks away from the trigger to notice any improvement.

What are the complications of occupational asthma?

Asthma attacks can be severe or even life-threatening if you can’t get enough air into your body. Repeated exposure to irritants can also sometimes cause lung problems, including scarring.

How is occupational asthma diagnosed?

An allergist or pulmonologist diagnoses occupational asthma by asking about the symptoms you’re experiencing and performing lung function tests. They’ll ask about your personal and family medical history.

Tell your provider what you do for work. This information will give your provider clues about what might be triggering asthma attacks.

Before your appointment, it can be helpful to keep track of when you have symptoms. Knowing when you have the worst symptoms will help your provider determine if you have work-related asthma and rule out other conditions.

What tests diagnose occupational asthma?

Your provider might use these tests to determine how well your lungs are working and rule out other conditions:

• Allergy blood tests or skin tests. These can determine if an allergy is triggering your asthma symptoms.
• Spirometry. This is a common lung function test that measures how well air flows through your lungs.
• Chest X-rays or CT scans. These can help your provider look for causes of your symptoms.
• A peak flow meter. This can measure how much your airways are restricted during certain activities (like when you’re at work).

How is occupational asthma managed?

Most people manage asthma with daily inhalers. These devices combine a medication that reduces inflammation (steroid) with a bronchodilator, which opens up your airways. Your provider will recommend avoiding things that trigger asthma as much as possible.

Your provider might also prescribe:

• A rescue inhaler. You’ll likely carry an inhaler that contains a fast-acting bronchodilator, like albuterol, in case you have an asthma attack.
• A nebulizer. Nebulizers spray a fine mist of medication through a mask on your face. You might use a nebulizer rather than an inhaler for some medications.
• Leukotriene modifiers. Your provider might prescribe a daily pill to help reduce asthma symptoms and your risk of an asthma attack.
• Biologic therapy. You might need additional medications if you have severe symptoms that don’t respond to other treatments.

Is there a cure for occupational asthma?

Just like other types of asthma, there’s no cure for occupational asthma. But you can manage it by avoiding the triggers and taking medications as prescribed by your provider.

Can occupational asthma be prevented?

The most important thing you can do to reduce your risk of occupational asthma is to avoid breathing in irritants. This might mean asking for a different assignment at work or changing jobs altogether, if possible.

Other ways you can reduce your risk of an asthma attack include:

• Wear a respirator mask. If you can’t avoid triggers, it might help to wear a mask that’s approved to filter the substances you’re working with.
• Work only in properly ventilated areas. Opening windows and doors can help, but may not be enough. Make sure there’s a proper exhaust system if you’re working with hazardous materials.
• Use substitutions for hazardous materials. Where possible, your employer may be able to use materials less likely to cause lung irritation.
• Check occupational safety and health standards. You can consult with your country’s or state’s occupational safety and health officials (like OSHA in the U.S.) to make sure your workplace meets their guidelines. They may also be able to make recommendations for a safer workplace.

What can I expect if I have occupational asthma?

If you have occupational asthma, you can expect to have fewer or no asthma attacks if you can avoid triggers — even though it’s not always easy to do. Medication can help, but if you’re exposed to irritants, you might still have symptoms. And continued exposure to irritants could damage your lungs permanently.

How long does it take to feel better if I avoid occupational asthma triggers?

It might take a few days or weeks to feel better after you’ve changed jobs or been away from something that causes asthma. You might continue having symptoms for longer. Ask your provider when they think you’ll start feeling better.

When should I see my healthcare provider?

Talk to your healthcare provider if you notice any asthma symptoms when you’re at work. Keep track of your symptoms, when they happen and if anything relieves them. Your provider can refer you to a specialist who can help you determine what’s causing your symptoms and what treatment options are available.

Your provider can also suggest how to discuss a diagnosis with your employer. They can offer ways to prevent further exposure and damage from occupational asthma.

When should I go to the ER?

If you have a severe asthma attack, you need immediate medical care. The first step is using a rescue inhaler.

If your rescue inhaler doesn’t help or you don’t have it with you, go to the nearest emergency room. Symptoms of a severe asthma attack include:

• Bluish skin, lips or fingernails (if you have lighter skin) or gray or white lips and gums (if you have darker skin)
• Feelings of anxiousness or panic
• Chest pressure or pain
• Severe wheezing or coughing that won’t stop
• Trouble talking
• Very rapid breathing

What questions should I ask my doctor?

It might be helpful to ask your healthcare provider:

• How do I take this medication/use this device?
• When should I use my rescue inhaler?
• When should I go to the ER?
• How can I avoid asthma attacks?
• Can I continue working at my job?
• Am I at risk for lung damage?