A respiratory condition is asthma. It causes a narrowing of the airways, which causes breathing difficulties, chest tightness, coughing, and breath-sounds like wheezing. Asthma that is brought on by a factor or circumstance at work is referred to as job-related asthma. There are two basic types of occupational asthma: The term ""occupational asthma"" describes cases of asthma brought on by particular substances in the job. It is possible to further categorize occupational asthma into two groups: Asthma brought on by a substance's ability to generate sensitization (reaction). Reactive airways dysfunction syndrome, or RADS, is another name for irritant-induced asthma, which is brought on by a single, intense exposure. Those with asthma who experience worsening symptoms at work are said to have it (e.g., factors at work may trigger, aggravate, or exacerbate existing asthma). Not all employees who are exposed to chemicals will experience an asthmatic reaction. By ceasing exposure to the chemical or by receiving medical treatment to alleviate the symptoms of asthma, asthma episodes can be controlled.
How does work-related asthma start to form?
Asthma Caused by Sensitizers
When the body is exposed to a material on a regular basis, it might occasionally become sensitized, which can cause an allergic reaction. The process typically takes time to develop and includes the immune system of the body; it is not always immediate. The body is shielded from damage brought on by external substances or germs by a sophisticated defensive system. Special proteins known as ""antibodies"" are among the defensive mechanism's most crucial components. When the human body comes into contact with a foreign material or germ, antibodies are created. Antibodies have the ability to react with chemicals or bacteria and eradicate them. Antibodies frequently exhibit high levels of specificity, working only on a single chemical or variety of microorganism. However, antibodies can also react incorrectly and result in diseases like asthma. A worker may begin manufacturing excessive amounts of the antibodies known as ""immunoglobulin E"" after being exposed to a drug for a period of time, whether it be natural or manufactured (IgE). These antibodies cause ""sensitization"" when they bind to particular lung cells. The sensitization may cause hay fever-like symptoms, skin rashes (urticaria), or a mix of these symptoms. It may also cause no symptoms at all. The lung cells that have IgE antibodies linked respond to the chemical upon re-exposure. Leukotrienes, which are produced in the body, are released as a result of this interaction. Some airway muscles contract as a result of leukotrienes. Asthma's characteristic constriction of the airways is brought on by this activity. With chronic, low-level exposure to an irritant, RADS may also manifest. Irritation-Provoked Asthma In this instance, the sickness is brought on by specific compounds' direct irritant effects on the airways. Reactive Airways Dysfunction Syndrome is the name given to this form of asthma (RADS). After a single, severe exposure to a high concentration of irritating chemicals, RADS may develop (e.g., chlorine, anhydrous ammonia and smoke). There isn't any lag. The symptoms start shortly after the exposure, typically within 24 hours, and may come back when the person is exposed to the irritants again months or years later.
How long does it take for asthma to start?
The onset of asthma can happen at any point in time. A few weeks to several years after the initial exposure, asthma can become a disease. Following are three fundamental types of asthmatic attacks that have been identified through analysis of the respiratory reactions of sensitized workers: Immediate: usually starts to manifest within minutes of exposure and peaks after 20 minutes; recovery takes around two hours. Lateness comes in many different guises. It usually starts several hours after exposure and is at its worst after about 4 to 8 hours with recovery within 24 hours. However, it can start 1 hour after exposure with recovery in 3 to 4 hours. In some cases, it may start at night, with a tendency to recur at the same time for a few nights following a single exposure. Dual or Combined – is the occurrence of both immediate and late types of asthma.
What factors increase the chances of developing asthma?
Some workplace conditions seem to increase the likelihood that workers will develop asthma, but their importance is not fully known. Factors such as the properties of the chemicals, and the amount and duration of exposure are important. However, because only a fraction of exposed workers are affected, factors unique to individual workers can also be important. Such factors include the ability of some people to produce abnormal amounts of IgE antibodies. The contribution of cigarette smoking to asthma is not known. However, smokers are more likely than nonsmokers to develop respiratory problems in general.
How does the doctor know if a worker has asthma?
Sufferers from work-related asthma experience attacks of difficult breathing, tightness of the chest, coughing, and breath sounds such as wheezing, which are associated with air-flow obstruction. Such symptoms should raise the suspicion of asthma. With work-related asthma, typically these symptoms are worse on working days, often awakening the patient at night, and improving when the person is away from work. While off work, sufferers from work-related asthma may still have chest symptoms when exposed to airway irritants such as dusts, or fumes, or upon exercise. Itchy and watery eyes, sneezing, stuffy and runny nose, and skin rashes are other symptoms often associated with asthma. The health care provider will also ask about your work history, including questions such as: Are symptoms worse at work? Do symptoms improve when away from work (e.g., vacation, weekends)? Did the symptoms start as an adult, or when you changed jobs? What type of industry do you work in? Are others at work experiencing similar symptoms? Lung function tests and skin tests can help to confirm the disease. However, some patients with work-related asthma may have normal lung function as well as negative skin tests. The diagnosis of work-related asthma needs to be confirmed objectively. This confirmation can be done by carrying out pulmonary function tests at work and off work. The tests will include serial spirometry or peak expiratory tests, specific inhalation challenge tests, or immunologic tests. Serial spirometry or peak expiratory tests are breathing tests. Through these tests, it is determined how much air and how fast a person can exhale. This technique determines the lung capacity and identifies a reduction in lung functions due to exposure. The measurements have to be taken couple of times per day and throughout the week. Specific inhalation challenges can demonstrate the occupational origin of asthma and may identify the agents responsible when the cause is uncertain. These tests require breathing in small quantities of industrial agents that may induce an attack of asthma. The method is safe when performed by experienced physicians in specialized centres. The immunologic tests are used to determine if a person is sensitized by a certain sensitizer.
How can we control work-related asthma?
Although there are medical treatments that may control the symptoms of asthma, it is important to stop exposure wherever possible. If the exposure to the substance is not stopped, treatment will be needed continuously and the breathing problems may become permanent. People may continue to suffer from work-related asthma even after removal from exposure. The best way to prevent work-related asthma is to replace substances with less harmful ones. Where this is not possible, exposure should be minimized through engineering controls such as ventilation and enclosures of processes. Information on a safety data sheet (SDS) should list any health hazards, as well as safe handling and control steps. Preventing further exposure might involve administrative controls such as medical screening and surveillance program for at-risk workers and a change of job or tasks. Education of workers is also very important. Proper handling procedures, avoidance of spills and good housekeeping reduce the occurrence of asthma. Masks or respirators can also help to control workplace exposure. Personal protective equipment is considered the last option for control measures. In order to be effective these protective devices must be carefully selected, properly fitted and well maintained as part of a full personal protective equipment (PPE) program.
What occupations are at risk for asthma?
Some of the occupations where asthma has been seen are listed in the following tables. It should be noted that the lists of occupational substances and microbes which can cause asthma are not complete. New causes continue to be added. New materials and new processes introduce new exposures and create new risks. Not specifically listed are common household and workplace triggers which include dust, mould, pollen, scents, and smoke. Table 1Causes of Work-related Asthma – Grains, flours, plants and gums Occupation Agent Bakers, millers, cooks Wheat, flours, grains, nuts, eggs, spices, additives. Also: moulds, mites, crustacea, etc. Chemists, coffee bean baggers and handlers, gardeners, millers, oil industry workers, farmers Castor beans Cigarette factory workers Tobacco dust Drug manufacturers, mold makers in sweet factories, printers Gum acacia Farmers, grain handlers Grain dust Gum manufacturers, sweet makers Gum tragacanth Strawberry growers Strawberry pollen Tea sifters and packers Tea dust Tobacco farmers Tobacco leaf Table 2 Causes of Work-related Asthma – Animals, animal substances, insects and fungi Occupation Agent Bird fanciers Avian proteins Cosmetic manufacturers Carmine Entomologists Moths, butterflies, cockroaches Feather pluckers Feathers Field contact workers Crickets Fish bait breeders Bee moths Flour mill workers, bakers, farm workers, grain handlers Grain storage mites, alternaria, aspergillus Laboratory workers Locusts, cockroaches, grain weevils, rats, mice, guinea pigs, rabbits Mushroom cultivators Mushroom spores Oyster farmers Hoya Pea sorters Mexican bean weevils Pigeon breeders Pigeons Poultry workers Chickens Prawn processors Prawns Silkworm sericulturers Silkworms Veterinary clinic, animal breeders Secretions from saliva, feces, urine and skin from various animals (cats, dogs, rabbits, horses, birds, rodents, etc.) Woollen industry workers Wool Zoological museum curators Beetles Table 3 Causes of Work-related Asthma – Chemicals/Materials Occupation Agent Adhesive industry Various agents including amines, acrylates, aldehydes, styrene, etc. Aircraft fitters Triethyltetramine Aluminum cable solderers Aminoethylethanolamine Aluminum pot room workers Fluorine Autobody workers Acrylates (resins, glues, sealants, adhesives), metals, amines, anhydrides, acrylates, urethanes, polyvinyl chloride, etc. Brewery workers Chloramine-T, mould Chemical plant workers, pulp mill workers Chlorine, formaldehyde, acid/alkaline gas, vapours, aerosols, sulphites Dentists, dental workers Acrylates, latex Dye weighers Levafix brilliant yellow, drimarene brilliant yellow and blue, cibachrome brilliant scarlet Electronics workers Colophony Epoxy resin manufacturers Tetrachlorophthalic anhydride Foundry mold makers Furan-based resin binder systems Fur dyers Para-phenylenediamine Hairdressers Persulphate salts, henna, formaldehyde, etc. Health care workers Glutaraldehyde, latex, certain drugs, sterilizing agents, disinfectants, etc. Janitor, service, cleaning Chloramines, amines, pine products, some fungicides and disinfectants, acetic acid, etc. Also: mixing chlorine bleach with ammonia Laboratory workers, nurses, phenolic resin molders Formalin/formaldehyde, detergent, enzymes Meat wrappers Polyvinyl chloride vapour Paint manufacturers, plastic molders, tool setters, Paint sprayers Phthalic anhydride, latex, diisocyanates, amines, chromium, acrylates, formaldehyde, styrene, dimethylethanolamine etc. Photographic workers, shellac manufacturers Ethylenediamine Refrigeration industry workers CFCs Solderers Polyether alcohol, polypropylene glycol Table 4 Causes of Work-related Asthma – Isocyanates and metals Occupation Agent Boat builders, foam manufacturers, office workers, plastics factory workers, refrigerator manufacturers, TDI manufacturers/users, printers, laminators, tinners, toy makers Toluene diisocyanate Boiler cleaners, gas turbine cleaners Vanadium Car sprayers Hexamethylene diisocyanate Cement workers Potassium dichromate Chrome platers, chrome polishers Sodium bichromate, chromic acid, potassium chromate Machinist, mechanic, metal workers, fabricating Cobalt, vanadium, chromium, platinum, nickel, metal working fluids, amines Nickel platers Nickel sulphate Platinum chemists Chloroplatinic acid Platinum refiners Platinum salts Polyurethane foam manufacturers, printers, laminators Diphenylmethane diisocyanate Rubber workers Naphthalene diisocyanate Tungsten carbide grinders Cobalt Welders Stainless steel fumes Table 5 Causes of Work-related Asthma – Drugs and enzymes Occupation Agent Ampicillin manufacturers Phenylglycine acid chloride Detergent manufacturers Bacillus subtilis Enzyme manufacturers Fungal alpha-amylase Food technologists, laboratory workers Papain Pharmacists Gentian powder, flaviastase Pharmaceutical workers Methyldopa, salbutamol, dichloramine, piperazine dihydrochloride, spiramycin, penicillins, sulphathiazole, sulphonechloramides, chloramine-T, phosdrin, pancreatic extracts Poultry workers Amprolium hydrochloride Process workers, plastic polymer production workers Trypsin, bromelin Table 6Causes of Work-related Asthma – Woods Occupation Agent Carpenters, timber millers, woodworkers, sawmill workers, pattern makers, wood finishers, wood machinists Western red cedar, cedar of Lebanon, iroko, California redwood, ramin, African zebrawood, ash, African maple, Australian blackwood, beech, box tree, Brazilian walnut, ebony, Mansonia, oak, mahogany, abiruana, spruce, Cocabolla, Kejaat, etc. Also: insects, mould, lacquers, etc. Acknowledgement The Canadian Centre for Occupational Health and Safety (CCOHS) would sincerely like to thank the Ontario Lung Association for their assistance in developing this document.""" - https://www.affordablecebu.com/
