Work-related asthma

Is there a link between work and asthma?

Yes! Work-related asthma is more common than you might think.  

It is estimated that about 15% of all adult-onset asthma is caused by harmful triggers at work. 

Around the world, about 25% of adults have work-related asthma.  

Work-related asthma tends to be more severe than asthma that’s not work-related.  

Are there different types of work-related asthma?

There are two general types of work-related asthma: 

• When asthma is caused by hazards at work. This is called Occupational Asthma (OA) 

• When people who already have asthma find that their symptoms get worse due to triggers at work.  This is called Work Exacerbated Asthma (WEA). WEA can also be caused by something non-specific about the workplace like temperature, humidity, physical exertion or stress.  

Things that can cause occupational asthma:

Hundreds of different causes for occupational asthma have been identified. These include: 

• Bioaerosols e.g. 

• • Dust (from plants, wood, foods, animal dander, metals etc) 

• • Flour 

• • Pollen 

• • mould/yeast 

• Industrial cleaning and sterilising agents (e.g. formaldehyde, bleach, hydrogen peroxide, cleaning enzymes) 

• Latex 

• Metals  

• Mites 

Things that can cause work exacerbated asthma include:

• Irritants such as cleaning products, bleach, smoke, fumes and dusts  

• Allergens in your workplace that you are sensitive to such as moulds, dust mites, animal dander and pollens  

• Poor ventilation that can increase the amount of exposure to triggers 

• Stress (from hot/cold temperatures, physical and emotional strain) 

What are the risk factors for getting occupational asthma?

Exposure to a substance at work that can potentially trigger asthma doesn’t mean asthma will happen straight away. It can take time for the body to develop a significant reaction, sometimes years. Development of problems is more likely in people who are more heavily exposed, or who have predisposing features such as their genetic make-up, other allergies or smoking. Nasal symptoms (sneezing, running or blocking) might occur first. 

Diagnosis of work-related asthma

It is important to explore a diagnosis of work-related asthma as early as possible with your doctor, to reduce exposure to your trigger. They will often need to refer you to an asthma specialist.  

Diagnosis is based on: 

• Medical history 

• History of exposure to triggers at work 

• Physical examination 

• Medical tests eg lung function and allergy tests 

What to discuss with your doctor?

• The kind of work you do, where you work and what you wear to do it 

• Whether you have been exposed to dust, fumes, chemicals or other triggers at your workplace (past and present) 

• Whether respiratory symptoms are better when away from work, such as on weekends or holidays 

• Whether you think that your symptoms are related to your work  

What if your doctor thinks you may have occupational asthma?

They will refer you to an asthma specialist. You will take a more detailed account of your working life and do tests to confirm a diagnosis. A diagnosis of occupational asthma cannot be made just from your history. 

Tests may include: 

• Peak flow testing:  This is often done four times a day, both at work and off work for about a month. This can sometimes show that it isn’t asthma that is causing symptoms. 

• Your doctor may also ask you to keep a diary to record what times you do certain tasks at work or are exposed to certain substances.  

• Allergy testing: These test whether you are sensitised to something you are exposed to at work. This does not confirm occupational asthma but is helpful information. 

• Other standard respiratory tests such as exhaled nitric oxide, non-specific challenge tests, or imaging with a CT of your chest may well be needed to confirm asthma and rule out other conditions.  

• Occasionally, challenge tests are done, which involve lung function tests before and after you are exposed to a small amount of the agent that give you symptoms. 

• Specialist occupational respiratory teams sometimes visit people’s work (with permission) if it is unclear what is causing the problem. 

Management of work-related asthma

• Elimination: The best thing to do would be to completely avoid exposure to the triggers by changing jobs, either to another role in your workplace or to a different location completely 

• Substitution: Replace the hazard where possible  

• Engineering controls: Isolate the person from the harmful triggers  

• Changing the way people work: This could include exhaust ventilation, changing equipment, work practices or policies and procedures 

• Personal protective equipment: Such as a powered hood (a type of respirator) to wear whilst working  

Once diagnosis is confirmed by a specialist, medical management of occupational asthma is based on asthma management guidelines. Usually, the person will need to continue some kind of preventer treatment even if they leave their job.  

It is also to manage other problems that come along with occupational asthma, such as nasal symptoms or inducible laryngeal obstruction.  

We know that management of occupational asthma can be difficult with the financial stress and uncertainty that changing jobs often causes. For a free consult with a friendly Asthma Educator, call 1800 ASTHMA (1800 278 462) or book a call below. 

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Recovery

Complete avoidance of the work triggers gives you the best chance of recovery. Improvements are generally seen within two years of removing the exposure, but it can take longer. 

People with an early diagnosis of occupational asthma and a shorter exposure time are likely to have better outcomes. Unfortunately, many people seek help late when some permanent damage has already been done. 

If affected people do return to work, it is very important that they have ongoing management to reduce flare-ups of the condition.  

Some people with occupational asthma may be entitled to compensation to cover loss of earnings or costs of medical treatment. This is something Asthma Australia are unable to advise on. 

If you think you may have work-related asthma, see your doctor as soon as possible.