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What is it?
Acute Occupational Asthma is a condition of sudden onset. It is caused by an allergic reaction causing an asthmatic reaction. In some situations, this asthmatic condition may persist after the patient has been removed from further exposure to the substance that caused the initial asthmatic reaction.
The diagnosis requires there to be asthma, and a work-related cause for this.
Symptoms
Cough, shortness of breath and/or wheeze. Typically Occupational Asthma symptoms occur some hours after exposure (for example the night following a day’s work). They are usually worse following work and improved away from work (for example on the weekends or during holidays).
Incidence
It is estimated that in the UK 7000 cases of asthma are caused or made worse by work each year and allergy to the proteins in natural rubber latex is the fifth largest occupational cause of asthma. (Croner.CCH Group Limited 2003.)
The seven top causes of occupational asthma are from exposure to:
Isocyanates
Flour and grain
Glutaraldehyde
Wood dust
Latex
Solder or colophony
Glues or resins.
Key Points
Red flag conditions
Significant shortness of breath
Sudden onset, or sudden deterioration
Uncontrolled, on asthma medication
Significant Upper Respiratory Tract symptoms
Significantly disturbed sleep pattern
Yellow flag conditions
Attitudes and beliefs about pain/illness
Emotions
Behaviours
Family
Compensation issues
Work
Diagnostic and treatment issues
Workplace conflict
Prognosis
Consider role of irritation and allergic sensitization processes. Is this worker fit to continue to be exposed to the precipitating cause?
Possible alternate duties
No exposure to irritant/noxious gases or fumes
Avoid exposure to the cold (specify temperature or location – e.g. Cold store)
When to Consider Referral for a Specialist Opinion:
The presence of any red flag conditions
The worker has had more than two weeks certified unfit for duties, or more than one month on selected duties
The worker has had more than three weeks off work, or on selected duties and has significant yellow flag conditions
Not back at pre-injury duties within six weeks of the injury.