In the U.S. alone, more than 25 million people are known to have asthma. For those with the chronic lung disease, which narrows airways and can cause problems ranging from chest tightness to shortness of breath and coughing, potential hazards can lurk in every environment: your home, outside — and the workplace.
Research continues to expand the understanding of agents that may cause a person to develop asthma and worsen symptoms on the job — from cleaning chemicals to dust from industrial processes. “There’s over 350 known agents that are associated with developing asthma or causing work-related asthma,” says Dr. Jacek Mazurek, a lead research epidemiologist at the National Institute for Occupational Safety and Health, which is part of the Centers for Disease Control and Prevention. Work-related asthma includes both what’s called occupational asthma — where the disease is caused by factors at work — and work-exacerbated asthma, in which a person’s asthma is worsened by factors related to work. When people suffer from work-related asthma, studies find they’re more likely to take sick days, use more health care resources and have a lower quality of life.
Modern medications have greatly improved our ability to manage asthma, says Dr. James Murphy, a pulmonologist at Miami Valley Hospital in Dayton, Ohio. So a person needn’t perfectly control his or her exposures to potential triggers that might cause or worsen asthma; however, he says it remains of tantamount importance that people with asthma reduce exposures at home, outside and on the job. “Far and way, the top most important thing is to reduce the number of trigger particles that your breathe into your lungs,” Murphy says. “If they can’t improve their air quality and reduce the amount of triggers that are inflaming their lungs, then we’re not going to achieve our goal of asthma control.”
[See: 7 Lifestyle Tips to Manage Your Asthma.]
Asthma in the Workforce
Recently, the CDC looked at asthma rates among employed adults by industry and occupation in 21 states, from California to New York. The health care and social service industry had the highest proportion of workers reporting they had asthma (10 percent). Retail trade, which ranges from car dealers to clothing stores, and education, which includes teachers and other staff in the field, also ranked among industries with the highest asthma prevalence at about 9 percent each.
As noted by the study authors, as well as outside experts, the research had a number of limitations. For example, participants self-reported that they had asthma (so it could have been misclassified), and researchers didn’t go so far as to prove asthma was work-related (or what proportion of workers who had asthma, had work-related asthma). But based on survey results from the research, “as many as 2.7 million U.S. workers might have asthma caused by or exacerbated by workplace conditions,” wrote Katelynn Dodd, an epidemiologist and associate service fellow at NIOSH, who led the study, and Dr. Jacek Mazurek, who co-authored the research.
“Each of the industries and occupations identified in this report is associated with a specific set of existing and emerging workplace exposures,” the researchers wrote. Those range from irritant chemicals to emotional stress, temperature and physical exertion associated with work-related asthma. Previous research has shown, for instance, that those working in the health care and social assistance industry — which includes professionals ranging from doctors, dentists and home health care providers to staff at diagnostic laboratories and nursing homes — may be exposed not only to potent cleaners and disinfectants but powdered latex gloves and aerosolized medications that increase the likelihood a person will develop asthma. Based on past research on education services, Mazurek says the quality of buildings — where water has gotten into some buildings, which is associated with mold growth — and poor air quality may be reasons why a higher proportion of these workers have asthma.
Asthma triggers can lurk in office spaces, too. “Working in an indoor office that’s climate controlled … you’d think that [would] have no exposures. But if it’s in an old building, it does,” Murphy says — such as from dust accumulation or mold growth, like due to a leaky roof.
[See: Coping With Depression at Work.]
What’s a Working Person to Do?
First, don’t put in your two weeks just yet. For most, quitting a job out of concern it might have caused or could worsen asthma isn’t an option or a necessary strategy. “If you’re really very allergic to cats and dogs, you probably shouldn’t be a veterinarian,” says Dr. Karin Pacheco, an associate professor of medicine and expert in occupational allergic diseases at National Jewish Health in Denver. “Rarely do you have to take people out and say, ‘I’m sorry but you can’t go back, because your asthma’s too bad and you could die here.'”
Rather, experts say that in most cases when a person has worked-related asthma, the focus is on trying to identify triggers and reducing exposure to those, while staying on the job. First, though, a person must ensure they have a proper diagnosis of asthma from a specialist, such as an allergist or pulmonologist — as sometimes what a person thinks is asthma isn’t, notes Dr. Alexander Kim, an allergist and clinical assistant professor of medicine at UC San Diego Health.
Once that’s been established, in cases where a person believes asthma was caused or is worsened by work, it’s important to communicate that with the doctor. Often the doctor will not ask about that, experts say, so the patient must initiate the conversation. Ask, too, about the doctor’s experience dealing with work-related asthma, since it’s helpful to see a clinician who has experience in this area.
While most workers don’t develop asthma due to their work, many suffer from worsening of symptoms on the job. “The majority of work-related asthma is pre-existing asthma that is aggravated by exposures in the workplace,” Pacheco says. In some cases, reducing exposures may be simple: Perhaps the worker spends a lot of time working in an industrial freezing — where cold air could exacerbate his or her symptoms — or is seated next to a copy machine, which spews fine particles that have been shown to be asthma triggers. So the first worker might ask to work in the general warehouse rather than the freezer, if possible, and the other worker to sit somewhere away from the copy machine, she says. In other cases, putting a HEPA — or high efficiency particulate air — filter in your office in a dusty building could meaningfully improve air quality in one’s “personal microenvironment,” Murphy says.
But often — as in cases where a worker believes their workplace caused their asthma — it can be difficult to identify the agents to blame, experts say. Sometimes they’re never known or determined. Clinicians say patients and their doctors should have a detailed conversation about their work environment, including when and where they’re most symptomatic, as part of an effort to determine that. If you work with hazardous chemicals, your employer may be required to provide Safety Data Sheets that you should share with your doctor to help determine if that may contribute to work-related asthma.
[See: 8 Surprising Facts About Asthma and Seasonal Allergies.]
Kim says he sometimes recommends having an industrial hygienist, or occupational hygienist, test for agents that could be causing work-related asthma, since not all of these would be necessarily readily familiar to the doctor. “There’s so many different agents and across many different industries,” he says. Experts say that can make it difficult to determine what’s contributing to work-related asthma — and all the more important to do due diligence to reduce exposures on the job.
More from U.S. News
Which Practitioner Do I See, and When?
10 Cold and Flu Myths Debunked
Is Your Job to Blame for Your Asthma? originally appeared on usnews.com
