Occupational Asthma

In December 2003, scientists released the results of a survey, which found that bakers, timber works, dentists, and waitresses are the workers reporting the highest rates of adult-onset asthma. The survey results also indicate the people most likely to develop occupational asthma are those with a personal family history of allergies or asthma and frequent exposure to highly sensitizing substances

Occupational asthma is the most common work-related lung disease in many industrialized countries. Although estimates vary, it is thought that 15% of adult-onset asthma cases in the United States may be attributable to workplace exposures. The Occupational Safety and Health Administration (OSHA) estimates 11 million workers in the United States are exposed to at least one of the almost 400 substances known to be associated with occupational asthma.

The most common substances associated with workplace asthma are:

Organic dusts: such as flour, cereals, grains, wood, coffee, tea and flax
Chemical dusts: such as vapors, plastics, paints, epoxies, insulation and
Minerals dusts: such as platinum, chromium, cotton, nickel sulfate

Sensitizing asthma tends to develop slowly after repeated exposures. This allergy-related asthma is the most commonly diagnosed form of occupational asthma. 

Preexisting Occupational Asthma: This type involves a preexisting asthma condition that is significantly aggravated after exposure to an irritating substance in the workplace and

Reactive Airway Dysfunction Syndrome (RADS): This third type of occupational asthma can occur after one or more exposures to high levels of airway irritants. (Common irritants that may cause this are hydrochloric acid, chlorine, acetic acid, and ammonia fumes.  Initial symptoms may include shortness of breath, wheezing, cough, and respiratory distress.  Although the initial symptoms usually improve, even a single exposure can result in long-term reactive airway dysfunction. 

Symptoms of work-place asthma include wheezing, chest tightness, coughing, and shortness of breath. Symptoms usually occur while the worker is exposed to a particular substance at work. In some cases, symptoms may not develop until several hours after work. In the early stages symptoms usually decrease or disappear during weekends or vacations, only to flair up after returning to work. In later stages of the disease, common substances such as cigarette smoke, dust, or cold air may trigger asthma symptoms. 

Diagnosis and Treatment: Allergists and immunologist specialists are generally those with the most experience diagnosing and treating occupational asthma. When occupational asthma is suspected, thorough medical and work histories are taken, and a complete physical examination is performed. The frequency, duration, and severity of symptoms are also noted. 

Laboratory tests of blood and sputum may help confirm the presence of specific irritants and assist in diagnosing occupational asthma. 

An important aspect of treatment for occupational asthma is simply to avoid the substance causing the asthma.  Employers sometimes provide affected workers with a different job, or allow the person to do their job in a different location within the facility. In addition to avoidance, aggressive drug treatment and regular monitoring are usually recommended. Many people require life-long treatment to control their occupational asthma.

If you have any further questions please contact our hotline:

Advanced Allergy and Asthma, PLLC
Ellen Epstein, M.D. FAAAAI
Adult and Pediatric Allergy
165 N. Village Ave.-Suite 141
Rockville Centre, NY 11570

Dr. Ellen Epstein is a Board Certified Adult and Pediatric Allergist and immunologist  in practice since 1986.  Dr. Epstein earned her M.D. degree from New York University School of Medicine.  She teaches at and is on the staff of Long Island Jewish Medical Center, Franklin Hospital Medical Center and South Nassau Communities Hospital.  She and her staff provide expert professional treatment in a warm and caring atmosphere.


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