Some of the jobs associated with occupational asthma

Occupational asthma is caused by breathing in chemical fumes, gases, dust or other substances at work. It can cause chest tightness, wheezing and shortness of breath. It is important to identify it early so it is reversed and long-term exposure to triggering substances is avoided. Treatment generally includes taking medication to reduce symptoms. But the only sure way to eliminate symptoms and prevent lung damage is to avoid triggers.

Severe asthma attacks can be life-threatening. Signs of an asthma attack that needs emergency treatment include:

• Rapid worsening of shortness of breath or wheezing
• No improvement even after using short-acting bronchodilators
• Shortness of breath with minimal activity

See a doctor if you have breathing problems as this may be a sign of asthma. The longer you are exposed to a substance that causes occupational asthma, the worse your symptoms will become, and the longer it will take for them to improve once you end your exposure to the irritant.

In some cases, exposure to airborne asthma triggers can cause permanent lung changes and lifetime asthma symptoms. Occupational asthma symptoms depend on the substance you’re exposed to, for how long and how often, among other factors.

Your symptoms may:

• Get worse as the week progresses, go away during weekends and vacations, and recur when you return to work.
• Occur at work and at home.
• Start as soon as you’re exposed to an asthma-inducing substance at work or after a period of regular exposure to the substance.
• Continue after exposure is stopped.

Causes

More than 300 workplace substances have been identified as causes of occupational asthma.

These substances include:

• Animal substances: such as proteins found in dander, hair, scales, fur, saliva and body wastes.
• Chemicals: such as anhydrides, diisocyanates and acids used to make paints, varnishes, adhesives, laminates and soldering resin. Other examples include chemicals used to make insulation, packaging materials, and foam mattresses and upholstery.
• Enzymes: used in detergents and flour conditioners.
• Metals: particularly platinum, chromium and nickel sulphate.
• Plant substances: including proteins in natural rubber latex, flour, cereals, cotton, flax, hemp, rye, wheat and papain, a digestive enzyme derived from papaya.
• Respiratory irritants: such as chlorine gas, sulphur dioxide and smoke.

Risk factors

You’re at increased risk if:

• You have allergies or another type of asthma.
• Asthma runs in your family.
• You work around known asthma triggers.
• You smoke.

High-risk occupations

Your risk is higher if you work in certain occupations.

Here are some of the riskiest jobs and the asthma-producing substances associated with them:

• Adhesive handlers
• Animal handlers, veterinarians
• Bakers, millers
• Mine workers
• Carpet makers
• Metal workers
• Forest workers, carpenters
• Hairdressers
• Health care workers
• Pharmaceutical workers
• Spraypainters
• Textile workers
• Users of plastic

Symptoms:

• Wheezing
• Coughing
• Shortness of breath
• Chest tightness
• Runny nose
• Nasal congestion
• Eye irritation and tearing

Diagnosis

An asthma diagnosis needs to be confirmed by lung (pulmonary) function tests and an allergy skin prick test.

Lung function tests include:

• Spirometry. You take deep breaths and forcefully exhale into a hose connected to a spirometer. If key measurements are below normal, your airways may be blocked by inflammation which is a key sign of asthma. You inhale a bronchodilator drug then retake the test. If your measurements improve significantly, it’s likely you have asthma.
• Peak flow measurement. Your doctor may ask you to carry a peak flow meter, a small handheld device that measures how fast you can force air out of your lungs. The slower you exhale, the worse your condition.
• Nitric oxide test. A high level in your breath may indicate asthma.

Treatment

Long-term asthma control medications, such as inhaled corticosteroids, are the cornerstone of treatment. If you have an asthma flare-up, a quick-relief inhaler can ease symptoms right away. Prevention If you smoke, quit. Avoid exposure to industrial pollution, car emissions, natural gas stoves and chlorine. Common household substances can aggravate occupational asthma.

Air conditioners, dehumidifiers and thorough cleaning can minimise exposure to these substances. If your job exposes you to risk of occupational asthma your company is legally obliged to protect you under the Occupational Health and Safety Act.

Dr Dulcy Rakumakoe. Picture: Refilwe Modise

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