Occupational asthma is asthma that’s caused or worsened by breathing in a workplace substance, such as chemical fumes, gases or dust. Like other types of asthma, occupational asthma can cause symptoms, such as chest tightness, wheezing and shortness of breath.
When diagnosed and treated early, occupational asthma may be reversible. Long-term exposure to allergy-causing substances can cause worsening symptoms and lifetime asthma. Treatment for occupational asthma is similar to treatment for other types of asthma, and it generally includes taking medications to reduce symptoms. But the only sure way to eliminate your symptoms and prevent lung damage due to occupational asthma is to avoid whatever’s triggering it.
Symptoms
Occupational asthma symptoms are similar to those caused by other types of asthma. Signs and symptoms may include:
Wheezing, sometimes just at night
Coughing
Shortness of breath
Chest tightness
Other possible accompanying signs and symptoms may include:
Runny nose
Nasal congestion
Eye irritation and tearing
Occupational asthma symptoms vary from person to person and depend on the substance you’re exposed to, how long and how often you’re exposed, your body’s individual reaction, and other factors. Your symptoms may vary and can include symptoms that:
Get worse as the work week progresses, go away during weekends and vacations, and recur when you return to work.
Occur both at work and away from work.
Start right after exposure to an asthma-inducing substance at work.
Start after months or even years of regular exposure to an asthma-inducing substance.
Continue after exposure is stopped. The longer you’re exposed to the asthma-causing substance, the more likely you’ll have long-lasting or permanent asthma symptoms
Causes
More than 300 workplace substances have been identified as possible 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 sulfate.
Plant substances, including proteins found 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, sulfur dioxide and smoke.
Complication
The longer you’re 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.
Treatment
The right medication for you depends on a number of things, including your age, symptoms, asthma triggers and what seems to work best to keep your asthma under control.
1. Long-term control medications
In most cases, these medications need to be taken every day. Types of long-term control medications include:
Inhaled corticosteroids. These medications include fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex), ciclesonide (Alvesco), beclomethasone (Qvar) and others. They are the most commonly prescribed type of long-term asthma medication. You may need to use these medications for several days to weeks before they reach their maximum benefit.
Leukotriene modifiers. These oral medications include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo CR). They help prevent asthma symptoms for up to 24 hours.
Theophylline. This is a daily pill that helps keep the airways open (bronchodilator). Theophylline (Theo-24, Elixophyllin, others) relaxes the muscles around the airways to make breathing easier. It’s not used as often now as in past years because more-effective medications are available.
Long-acting beta agonists (LABAs). These inhaled medications include salmeterol (Serevent Diskus) and formoterol (Foradil). LABAs open the airways and reduce inflammation. However, they’ve been linked to severe asthma attacks. LABAs should only be taken only in combination with an inhaled corticosteroid.
Combination inhalers such as fluticasone and salmeterol (Advair Diskus, Advair HFA) and budesonide and formoterol (Symbicort) and mometasone and formoterol (Dulera).
2. Quick-relief medications
Also called rescue medications, quick-relief medications are used as needed for rapid, short-term symptom relief during an asthma attack — or before exercise if your doctor recommends it. Types of quick-relief medications include:
Short-acting beta agonists. These inhaled bronchodilator (brong-koh-DIE-lay-tur) medications can rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA) and pirbuterol (Maxair Autohaler). These medications act within minutes, and effects last several hours.
Ipratropium (Atrovent). Your doctor might prescribe this inhaled mediation for the immediate relief of your symptoms. Like other bronchodilators, ipratropium relaxes the airways, making it easier to breathe. Ipratropium is mostly used for emphysema and chronic bronchitis, but it’s sometimes used to treat asthma attacks.
Oral and intravenous corticosteroids. These medications relieve airway inflammation caused by severe asthma. Examples include prednisone and methylprednisolone (Medrol). They can cause serious side effects, such as high blood pressure, weight gain and an increased risk of infection, when used long term, so they’re only used to treat severe asthma symptoms on a short-term basis.
3. Treatment for allergy-induced asthma
If your asthma is triggered or worsened by allergies, you may benefit from allergy treatment as well. Allergy treatments include:
Allergy medications. These include oral and nasal spray antihistamines and decongestants as well as corticosteroid, cromolyn (NasalCrom) and ipratropium (Atrovent) nasal sprays.
Allergy shots (immunotherapy). Immunotherapy injections are generally given once a week for a few months, then once a month for a period of three to five years. Over time, they gradually reduce your immune system reaction to specific allergens.
Omalizumab (Xolair). This medication, which is given by injection, is specifically for people who have difficult to control allergies and asthma. It reduces the immune system’s reaction to allergy-causing substances, such as pollen, dust mites or pet dander.
Preventions
Although you may rely on medications to relieve symptoms and control inflammation associated with occupational asthma, you can do several things on your own to maintain overall health and lessen the possibility of attacks:
If you smoke, quit. In addition to all its other health benefits, being smoke-free may help prevent or lesson symptoms of occupational asthma.
Avoid irritating gases. Occupational asthma may be worsened by exposure to industrial pollution, automobile emissions, natural gas stoves, and chlorine used in swimming pools.
Get regular exercise. Regular exercise can strengthen your heart and lungs so that they don’t have to work so hard. If you’ve been inactive, start slowly and gradually increase your activity over time. Avoid exercising outdoors during pollution alerts or when the temperature is below zero. Discuss any exercise program with your doctor.
Minimize household allergens. Common household substances, such as mold, pollen, dust mites and pet dander, can aggravate symptoms of occupational asthma. Air conditioners, dehumidifiers and thorough cleaning practices, especially in your bedroom, can minimize your exposure to these substances and help you breathe easier.