Occupational Asthma

  • Medical Author:
    Syed Shahzad Mustafa, MD

    After growing up in the Rochester area, Dr. Mustafa pursued his undergraduate studies at the Johns Hopkins University in Baltimore and attended medical school at SUNY Buffalo. He then completed his internal medicine training at the University of Colorado and stayed in Denver to complete his fellowship training in allergy and clinical immunology at the University of Colorado, National Jewish Health, and Children's Hospital of Denver.

  • Medical Author: Allison Ramsey, MD
    Allison Ramsey, MD

    Dr. Allison Ramsey earned her undergraduate degree at Colgate University and her medical degree at the University of Rochester School of Medicine and Dentistry. She completed her internal medicine training at the University of Rochester School of Medicine and Dentistry and remained at the university to complete her fellowship training in allergy and clinical immunology. Dr. Ramsey is board certified in internal medicine and allergy and immunology. Her professional interests include the treatment of drug allergy and eosinophilic disorders. She also enjoys teaching medical trainees. She is a member of the American Academy of Allergy, Asthma, and Immunology, the American College of Allergy, Asthma, and Immunology, the New York State Allergy Society, and the Finger Lakes Allergy Society. In her personal life, her interests include exercise, especially running and horseback riding; and spending time with her husband and two children.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Quick GuideAsthma Attack Signs, Treatments, and Prevention

Asthma Attack Signs, Treatments, and Prevention

What are symptoms and signs of occupational asthma?

Symptoms usually begin with wheezing, shortness of breath, and chest tightness weeks to years after workplace exposure. Often, runny nose (rhinorrhea) and inflammation of the lining around the eyes (conjunctivitis) are present as well and may even occur before any wheezing or shortness of breath develops. Occasionally cough with or without phlegm (sputum) production may be present as well.

Initially, patients may notice that their symptoms are worse at work and better during weekends or holidays away from work. If no action is taken, patients may develop constant symptoms.

The latency period between the time of exposure to the time of onset of symptoms is highly variable. The latency period for occupational asthma caused by low-molecular weight compounds seems to be shorter than that for high-molecular weight compounds. The latency period for high-molecular weight compounds is often several years.

A severe form of irritant-induced occupational asthma is called reactive airways dysfunction syndrome (RADS). This is a condition where the patient suffers a single exposure to a very high concentration of a noxious chemical, usually a gas. A person suffering from RADS will have shortness of breath and chest tightness severe enough to seek medical attention within 24 hours of the exposure. After recovery from the initial massive exposure, the patient will have airways that remain excessively reactive, or "twitchy," from stimulation by the agent that caused the initial symptoms or other agents. Almost all patients with RADS will have excessively responsive airways for three months, and 50%-60% will still have excessively responsive airways even 18 months later.

How do health-care professionals diagnose occupational asthma?

A thorough history and physical examination is performed for any patient in whom occupational asthma is suspected. Important questions include the type of symptoms, duration of symptoms, timing of symptoms, and factors that make symptoms better or worse. The characteristics of the workplace, including any inhalational exposures, is evaluated. Material Safety Data Sheets (MSDS) may contain helpful information about the workplace. These will generally be on site in your workplace.

A test to measure the flow of air in and out of your lungs, called spirometry or a pulmonary function test, may be performed. This test is used to define the diagnosis of asthma. This test may involve giving an inhaled medicine called a bronchodilator to relax or dilate the airways. Alternatively, the test may involve administering a medicine to see how excessively responsive, or twitchy, the airways are (bronchoprovocation test).

A peak expiratory flow meter may be recommended to measure airflow during exhalation both at home and at work. Typically, results are recorded daily for a few weeks to see if there is a difference in airflow at work and away from work. Skin tests can be done, where an agent thought to cause your symptoms is introduced below the first layer of skin with a small needle to see if this agent triggers an inflammatory response. However, skin tests are not available for most agents that cause occupational asthma.

Medically Reviewed by a Doctor on 11/1/2016

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