Acute occupational asthma

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:

1. Isocyanates

2. Flour and grain

3. Glutaraldehyde

4. Wood dust

5. Latex

6. Solder or colophony

7. 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.

More Information

Useful Information