Occupational asthma
Encyclopedia
Occupational asthma
is an occupational condition defined as:
Asthma
is defined as a respiratory disease caused by narrowing of the air passages. It is synonymous with difficulty in breathing
, tightness of chest, nasal irritation, coughing and wheezing. The first person to use it in reference to a medical condition was Hippocrates
, and he believed that tailors, anglers and metalworkers were more likely to be affected by the disease. Although much research has been done since, the inflammatory component of asthma was recognized only in the 1960s.
Today, asthma
affects as much as 15% of the Canadian population (and this is true of other developed countries too) and has increased fourfold in the last 20 years. Various reasons can be identified for this increase - Of course better diagnosis and facilities along with a greater awareness regarding the disease have played a major role. But, one cannot deny the part of increased environmental pollution. Researchers have been working on the relation between the environment and human health since long and the air we breathe is the primary cause for lung diseases like asthma
, rhinitis
, COPD
s, etc. that affect us today.
Approximately 10 to 15% of the adults affected by the disease report an aggravation of their symptoms while at work and an improvement when away, which implies that they may be suffering from Occupational Asthma. Thus, when an individual’s Asthma is caused, not aggravated, by workplace materials, it is defined as Occupational Asthma. In the USA, OA is considered the most common occupational lung disease.
At present, over 400 workplace substances have been identified as having asthmagenic or allergenic properties. Their existence and magnitude vary from region to region and the type of industry
and can be as varied as wood dust (cedar
, ebony
, etc.), persulfates (Hairsprays), zinc
or even seafood like prawns. For example, in France
the industries most affected in order of importance are Bakeries and cake-shops, automobile industry and hairdressers, whereas in Canada the principal cause is wood dust, followed by isocyanates.
Hypersensitivity pneumonitis
is a related condition, with many occupational examples (e.g. "Farmer's Lung", "Malt Worker's Lung" and "Humidifier Lung" etc.). However, although overlapping in many cases, hypersensitivity pneumonitis may be distinguished from occupational asthma in that it isn't restricted to only occupational exposure, and involves type III hypersensitivity
and type IV hypersensitivity
rather than type I hypersensitivity
of asthma. Unlike asthma, hypersensitivity pneumonitis targets lung alveoli rather than bronchi.
If these symptoms persist, the person is most likely suffering from OA. However, one must be aware that this could also be because the person is already suffering from asthma and his condition was simply aggravated by workplace irritants (Work-aggravated asthma). In this case, although he will suffer similar consequences as someone who is suffering from OA (loss of work, medical expenses, etc.), his disease cannot be considered as having an occupational origin.
However, the biggest challenge is the first step – Family doctors and patients alike do not have sufficient knowledge about Occupational Asthma - only 15% of the asthmatic patients are asked by their doctor if their symptoms are related to work. And often, patients do not mention this possibility due to the fear of losing their jobs or simply because they are not aware of the association between their work and asthma. What they do not realize is that if they continue working under such circumstances, not only are they sure to lose their job in the long run but their asthma will also reach an irreversible stage. Clearly, an incorrect diagnosis will have considerable medical, social and financial consequences.
Diagnosis of OA is a process and has to be done over a period of time. First, the patient’s occupational and clinical history is taken and his symptoms are charted (Charting is usually done at the end of a typical work week and within 24 hours of the occurrence of symptoms in order to get objective information). Once this has been established, the following diagnostic methods are used:
, the IgE test is performed to evaluate whether the subject is allergic to these substances.
can be defined as a device used to measure timed expired and inspired volumes. These volumes then enable us to measure how quickly the lungs can be emptied and filled and whether it is effective. These measurements need to be stated at body temperature, and the pressure will have to be saturated with water vapor to get the correct values. This is because, if the spirometer is dry the recorded volume of air displaced is lower than that actually displaced by the lungs.
“The Realistic Method” is a whole body sealed chamber where the patient is exposed to articles that are present in their workplace. This method has the advantage of being able to assess, albeit highly subjectively, ocular and nasal symptoms as well as a reduction in FEV1.
This test requires the patient to breathe aerosols of the suspected ‘asthmagen
s’ through an oro-facial mask. These ‘asthmagens’ are aerosolized using closed circuit chambers, and the quantities and concentrations administered being minute and extremely stable minimize the risk of exaggerated responses.
Of the above methods of doing a diagnosis, procedures such as monitoring of spirometry
or peak expiratory flow at work and Specific Inhalation Challenges (SIC) have been proved as the most objective and reliable methods.
(CCOHS) better education of workers, management, unions and medical professionals is the key to the prevention of OA. This will enable them to identify the risk factors and put in place preventive measures like masks or exposure limits, etc.
Recovery is directly dependent on the duration and level of exposure to the causative agent. Depending on the severity of the case, the condition of the patient can improve dramatically during the first year after removal from exposure.
Three basic types of procedures are used for treating the affected workers:
Short-acting beta-agonists like salbutamol
or terbutaline
or long-acting beta-agonists like salmeterol
and formoterol
or anticholinergic
, etc. dilate airways which relieve the symptoms thus reducing the severity of the reaction. Some patients also use it just before work to avoid a drop in the FEV1.
Anti-inflammatory agents like corticosteroid
s, LKTRA or mast cell stabilizers can be used depending on the severity of the case.
, Doctor of Philosophy and Medicine from Parma
, Italy
published the book “De Morbis Artificum Diatriba” (A Treatise on the Diseases of Workers). Although researchers like Olaus Magus had done work on diseases due to occupational causes as early as 1555, this was the first comprehensive work on work-related diseases. This volume described in detail the diseases of workers in 52 different occupations. Thus, it was the basis for the emergence of occupational medicine and even today, it is an important reference. Due to his important contribution to this field, Dr. Ramazzini is considered the father of occupational medicine.
Similarly, for his contribution to research on asthma in the workplace, Dr Jack Pepys is considered as the Father of Occupational Asthma. His work on the role of Aspergillus
species in pulmonary diseases as also on the cause of farmer’s lung have heavily influenced the emergence of OA as an occupational disease. And, thanks to his work on Specific Inhalation Challenge, the compensatible aspect of the disease was recognized.
Yet, the riskiest occupations for asthma are: adhesive handlers (e.g. acrylate
), animal handlers and veterinarians (animal proteins), bakers and millers (cereal grains), carpet makers (gums), electronics workers (soldering resin
), forest workers, carpenters and cabinetmakers (wood dust), hairdressers (e.g. persulfate
), health care workers (latex and chemicals such as glutaraldehyde
), janitors and cleaning staff (e.g. chloramine-T
), pharmaceutical workers (drugs, enzymes), seafood processors, shellac handlers (e.g. amines), solderers and refiners (metals), spray painters, insulation installers, plastics and foam industry workers (e.g. diisocyanates), textile workers (dyes) and users of plastics and epoxy resins (e.g. anhydrides)
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
is an occupational condition defined as:
"a disease characterized by variable airflow limitation and/or airway hyper-responsiveness due to causes and conditions attributable to a particular occupational environment and not stimuli encountered outside the workplace".
Asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
is defined as a respiratory disease caused by narrowing of the air passages. It is synonymous with difficulty in breathing
Breathing
Breathing is the process that moves air in and out of the lungs. Aerobic organisms require oxygen to release energy via respiration, in the form of the metabolism of energy-rich molecules such as glucose. Breathing is only one process that delivers oxygen to where it is needed in the body and...
, tightness of chest, nasal irritation, coughing and wheezing. The first person to use it in reference to a medical condition was Hippocrates
Hippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...
, and he believed that tailors, anglers and metalworkers were more likely to be affected by the disease. Although much research has been done since, the inflammatory component of asthma was recognized only in the 1960s.
Today, asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
affects as much as 15% of the Canadian population (and this is true of other developed countries too) and has increased fourfold in the last 20 years. Various reasons can be identified for this increase - Of course better diagnosis and facilities along with a greater awareness regarding the disease have played a major role. But, one cannot deny the part of increased environmental pollution. Researchers have been working on the relation between the environment and human health since long and the air we breathe is the primary cause for lung diseases like asthma
Asthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
, rhinitis
Rhinitis
Rhinitis , commonly known as a stuffy nose, is the medical term describing irritation and inflammation of some internal areas of the nose. The primary symptom of rhinitis is nasal dripping. It is caused by chronic or acute inflammation of the mucous membrane of the nose due to viruses, bacteria or...
, COPD
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...
s, etc. that affect us today.
Approximately 10 to 15% of the adults affected by the disease report an aggravation of their symptoms while at work and an improvement when away, which implies that they may be suffering from Occupational Asthma. Thus, when an individual’s Asthma is caused, not aggravated, by workplace materials, it is defined as Occupational Asthma. In the USA, OA is considered the most common occupational lung disease.
At present, over 400 workplace substances have been identified as having asthmagenic or allergenic properties. Their existence and magnitude vary from region to region and the type of industry
Industry
Industry refers to the production of an economic good or service within an economy.-Industrial sectors:There are four key industrial economic sectors: the primary sector, largely raw material extraction industries such as mining and farming; the secondary sector, involving refining, construction,...
and can be as varied as wood dust (cedar
Cedar wood
Cedar wood comes from several different trees that grow in different parts of the world, and may have different uses.* California incense-cedar, from Calocedrus decurrens, is the primary type of wood used for making pencils...
, ebony
Ebony
Ebony is a dense black wood, most commonly yielded by several species in the genus Diospyros, but ebony may also refer to other heavy, black woods from unrelated species. Ebony is dense enough to sink in water. Its fine texture, and very smooth finish when polished, make it valuable as an...
, etc.), persulfates (Hairsprays), zinc
Zinc
Zinc , or spelter , is a metallic chemical element; it has the symbol Zn and atomic number 30. It is the first element in group 12 of the periodic table. Zinc is, in some respects, chemically similar to magnesium, because its ion is of similar size and its only common oxidation state is +2...
or even seafood like prawns. For example, in France
France
The French Republic , The French Republic , The French Republic , (commonly known as France , is a unitary semi-presidential republic in Western Europe with several overseas territories and islands located on other continents and in the Indian, Pacific, and Atlantic oceans. Metropolitan France...
the industries most affected in order of importance are Bakeries and cake-shops, automobile industry and hairdressers, whereas in Canada the principal cause is wood dust, followed by isocyanates.
Hypersensitivity pneumonitis
Hypersensitivity pneumonitis
Hypersensitivity pneumonitis is an inflammation of the alveoli within the lung caused by hypersensitivity to inhaled organic dusts. Sufferers are commonly exposed to the dust by their occupation or hobbies.-Pathophysiology:Hypersensitivity pneumonitis involves inhalation of an antigen...
is a related condition, with many occupational examples (e.g. "Farmer's Lung", "Malt Worker's Lung" and "Humidifier Lung" etc.). However, although overlapping in many cases, hypersensitivity pneumonitis may be distinguished from occupational asthma in that it isn't restricted to only occupational exposure, and involves type III hypersensitivity
Type III hypersensitivity
Type III hypersensitivity occurs when antigens and antibodies are present in roughly equal amounts, causing extensive cross-linking.-Presentation:...
and type IV hypersensitivity
Type IV hypersensitivity
Type IV hypersensitivity is often called delayed type hypersensitivity as the reaction takes two to three days to develop. Unlike the other types, it is not antibody mediated but rather is a type of cell-mediated response....
rather than type I hypersensitivity
Type I hypersensitivity
Type I hypersensitivity is an allergic reaction provoked by reexposure to a specific type of antigen referred to as an allergen, or to a nonimmunologic stimulus like cold weather or exercise...
of asthma. Unlike asthma, hypersensitivity pneumonitis targets lung alveoli rather than bronchi.
Signs and symptoms
Less than five years of exposure to an occupational agent can be enough for the appearance of the first OA symptoms. This depends on whether the reason for the OA to occur was exposure to the causative agent over a period of time (with a latency period) or a single exposure to an irritant but at a very high concentration (without latency period). Both eventually result in OA. Coughing, wheezing, nasal irritation, difficulty in breathing, tightness of chest are the most common symptoms and can be recognized more easily by asking oneself the following questions:- Are any of the above symptoms recurrent/chronic?
- Are they present at work?
- Do they worsen towards the end of the work day and/or end of the week?
- Does the employee/worker feel an improvement in his condition when away from work, on vacation or on weekends?
If these symptoms persist, the person is most likely suffering from OA. However, one must be aware that this could also be because the person is already suffering from asthma and his condition was simply aggravated by workplace irritants (Work-aggravated asthma). In this case, although he will suffer similar consequences as someone who is suffering from OA (loss of work, medical expenses, etc.), his disease cannot be considered as having an occupational origin.
Diagnosis
Like for any other disease correct diagnosis is important. According to Dr. Susan Tarlo:“It is important to recognize, since if due to a workplace sensitizer and, if undetected and if the patient continues to work with even small exposure to the relevant sensitizing agent, the prognosis is worse”. She also concluded that, “the chance of eventual improvement in Asthma severity after stopping exposure decreases with the duration of exposure after the onset of the symptoms. The best chance of asthma clearing or significantly improving is associated with early diagnosis and early removal from ongoing exposure”.
However, the biggest challenge is the first step – Family doctors and patients alike do not have sufficient knowledge about Occupational Asthma - only 15% of the asthmatic patients are asked by their doctor if their symptoms are related to work. And often, patients do not mention this possibility due to the fear of losing their jobs or simply because they are not aware of the association between their work and asthma. What they do not realize is that if they continue working under such circumstances, not only are they sure to lose their job in the long run but their asthma will also reach an irreversible stage. Clearly, an incorrect diagnosis will have considerable medical, social and financial consequences.
Diagnosis of OA is a process and has to be done over a period of time. First, the patient’s occupational and clinical history is taken and his symptoms are charted (Charting is usually done at the end of a typical work week and within 24 hours of the occurrence of symptoms in order to get objective information). Once this has been established, the following diagnostic methods are used:
Non-specific bronchial hyperreactivity
A non-specific bronchial hyperreactivity test involves testing with methacoline, after which the Forced Expiratory Volume in 1 second (FEV1) of the patient is measured. This test is often used for measuring the intensity of a person's asthma and to confirm that the person needs to be treated for asthma. Other non specific tests could even require the patient to run in open air or on a treadmill for a few minutes at a continuous pace. In this case, the individual’s Peak Expiratory Flow Rate (PEFR) is measured. (The peak expiratory flow rate measures how fast a person can exhale).Skin prick tests
Although called skin prick test, it does not involve drawing blood, in fact, the skin is not even scratched. It is usually performed on the inner aspect of the forearm where grid is marked (using a simple marker) and a drop of the allergen that is to be tested is placed on the arm at the end of each line. All the allergens that need to be tested can be similarly placed on the grid. Once this has been done, the skin is pricked through the drop using a lancet. Reactions, if any, occur within 10 to 15 minutes and these results can then be analyzed.IgE-specific tests
Immunoglobulin E is an antibody found in human blood and is effective against toxins. Since it can also trigger allergic reactions to specific allergens like pollenPollen
Pollen is a fine to coarse powder containing the microgametophytes of seed plants, which produce the male gametes . Pollen grains have a hard coat that protects the sperm cells during the process of their movement from the stamens to the pistil of flowering plants or from the male cone to the...
, the IgE test is performed to evaluate whether the subject is allergic to these substances.
Spirometric tests
Conventionally, a spirometerSpirometer
A spirometer is an apparatus for measuring the volume of air inspired and expired by the lungs. It is a precision differential pressure transducer for the measurements of respiration flow rates. The spirometer records the amount of air and the rate of air that is breathed in and out over a...
can be defined as a device used to measure timed expired and inspired volumes. These volumes then enable us to measure how quickly the lungs can be emptied and filled and whether it is effective. These measurements need to be stated at body temperature, and the pressure will have to be saturated with water vapor to get the correct values. This is because, if the spirometer is dry the recorded volume of air displaced is lower than that actually displaced by the lungs.
Peak Expiratory Flow at work
This test uses the PEFR method. The only difference is that it measures the functioning of the patient's airways at his place of work and not necessarily in a controlled environment. The patient breathes into a Peak Expiratory Flow monitor (a hand-held device that has a mouth piece at one end and a scale with an indicator on the other).Specific inhalation challenge
- Realistic method
“The Realistic Method” is a whole body sealed chamber where the patient is exposed to articles that are present in their workplace. This method has the advantage of being able to assess, albeit highly subjectively, ocular and nasal symptoms as well as a reduction in FEV1.
- Closed-circuit method
This test requires the patient to breathe aerosols of the suspected ‘asthmagen
Asthmagen
An asthmagen is any substance that is causally-related to the development of asthma symptoms....
s’ through an oro-facial mask. These ‘asthmagens’ are aerosolized using closed circuit chambers, and the quantities and concentrations administered being minute and extremely stable minimize the risk of exaggerated responses.
Of the above methods of doing a diagnosis, procedures such as monitoring of spirometry
Spirometry
Spirometry is the most common of the pulmonary function tests , measuring lung function, specifically the measurement of the amount and/or speed of air that can be inhaled and exhaled...
or peak expiratory flow at work and Specific Inhalation Challenges (SIC) have been proved as the most objective and reliable methods.
Prevention and treatment
According to the Canadian Centre for Occupational Health and SafetyCanadian Centre for Occupational Health and Safety
The Canadian Centre for Occupational Health and Safety is a Crown corporation owned by the Government of Canada.CCOHS functions as the primary national agency in Canada for the advancement of safe and healthy workplaces and preventing work-related injuries, illnesses and deaths...
(CCOHS) better education of workers, management, unions and medical professionals is the key to the prevention of OA. This will enable them to identify the risk factors and put in place preventive measures like masks or exposure limits, etc.
Recovery is directly dependent on the duration and level of exposure to the causative agent. Depending on the severity of the case, the condition of the patient can improve dramatically during the first year after removal from exposure.
Three basic types of procedures are used for treating the affected workers:
1) Reducing exposure
This method is most effective for those affected by irritant-induced OA. Thus, by reducing their exposure duration and level to the causative agent, the probability of suffering another reaction is lowered. But exposure can be reduced in other ways like making use of face masks or providing better ventilation. Now, more and more di-isocyanate free spray paints are available. Similarly, most hospitals and healthcare companies have exchanged latex gloves for other materials. Thus, reducing exposure to known asthmagens can also be used as a preventive measure.2) Removal from exposure
Persons affected by OA that occurred after a latency period, whether a few months or years, must be immediately removed from exposure to the causative agent. This is their only chance of recovery. However, this entails severe socio-economic consequences for the worker as well as the employer due to loss of job, unemployment, compensation issues, quasi-permanent medical expenditures, hiring and re-training of new personnel, etc. Also, according to recent research the probability that those who suffer from OA remain unemployed longer than those who suffer from non-occupational asthma is higher. One solution to this problem is relocating the employee in the same company away from the causative agents.3) Medical and pharmacological treatment
Anyone diagnosed with Asthma will have to undergo medical treatment. This is complementary to either removing or reducing the patient’s exposure to the causal agents. Two types of medication can be used:- Relievers or bronchodilators
Short-acting beta-agonists like salbutamol
Salbutamol
Salbutamol or albuterol is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease. It is marketed as Ventolin among other brand names....
or terbutaline
Terbutaline
Terbutaline is a β2-adrenergic receptor agonist.Terbutaline is currently on the World Anti-Doping Agency's list of prohibited drugs for Olympic athletes, except when administered by inhalation and a Therapeutic Use Exemption has been obtained in advance.Terbutaline is currently used to delay...
or long-acting beta-agonists like salmeterol
Salmeterol
Salmeterol is a long-acting beta2-adrenergic receptor agonist drug that is currently prescribed for the treatment of asthma and chronic obstructive pulmonary disease. It is currently available as a dry powder inhaler that releases a powdered form of the drug...
and formoterol
Formoterol
Formoterol or eformoterol is a long-acting β2-agonist used in the management of asthma and/or chronic obstructive pulmonary disease...
or anticholinergic
Anticholinergic
An anticholinergic agent is a substance that blocks the neurotransmitter acetylcholine in the central and the peripheral nervous system. An example of an anticholinergic is dicycloverine, and the classic example is atropine....
, etc. dilate airways which relieve the symptoms thus reducing the severity of the reaction. Some patients also use it just before work to avoid a drop in the FEV1.
- Preventers
Anti-inflammatory agents like corticosteroid
Corticosteroid
Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte...
s, LKTRA or mast cell stabilizers can be used depending on the severity of the case.
History
In 1700, Bernardino RamazziniBernardino Ramazzini
Bernardino Ramazzini was an Italian physician.Ramazzini was an early proponent of the use of cinchona bark in the treatment of Malaria...
, Doctor of Philosophy and Medicine from Parma
Parma
Parma is a city in the Italian region of Emilia-Romagna famous for its ham, its cheese, its architecture and the fine countryside around it. This is the home of the University of Parma, one of the oldest universities in the world....
, Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...
published the book “De Morbis Artificum Diatriba” (A Treatise on the Diseases of Workers). Although researchers like Olaus Magus had done work on diseases due to occupational causes as early as 1555, this was the first comprehensive work on work-related diseases. This volume described in detail the diseases of workers in 52 different occupations. Thus, it was the basis for the emergence of occupational medicine and even today, it is an important reference. Due to his important contribution to this field, Dr. Ramazzini is considered the father of occupational medicine.
Similarly, for his contribution to research on asthma in the workplace, Dr Jack Pepys is considered as the Father of Occupational Asthma. His work on the role of Aspergillus
Aspergillus
Aspergillus is a genus consisting of several hundred mold species found in various climates worldwide. Aspergillus was first catalogued in 1729 by the Italian priest and biologist Pier Antonio Micheli...
species in pulmonary diseases as also on the cause of farmer’s lung have heavily influenced the emergence of OA as an occupational disease. And, thanks to his work on Specific Inhalation Challenge, the compensatible aspect of the disease was recognized.
Compensation
As mentioned earlier, when a person is diagnosed as having occupational asthma, it results in serious socio-economic consequences not only for the workers but also for the employer and the healthcare system. The employee has to be taken off job immediately to prevent any further damage to his health. And, the probability of being re-employed is lower for those suffering from OA as compared to those suffering from normal asthma. The employer not only pays compensation to the employee, but will also have to spend a considerable amount of time and energy and funds for hiring and training new personnel. In the United States, it was estimated that the direct cost of occupational asthma in 1996 was $1.2 billion and the indirect cost $0.4 billion, for a total cost of $1.6 billion.Occupations at risk
The following tables show occupations that are known to be at risk for occupational asthma, and main substances involved.Yet, the riskiest occupations for asthma are: adhesive handlers (e.g. acrylate
Acrylate
The acrylate ion is the ion of acrylic acid.Acrylates are the salts and esters of acrylic acid. They are also known as propenoates ....
), animal handlers and veterinarians (animal proteins), bakers and millers (cereal grains), carpet makers (gums), electronics workers (soldering resin
Resin
Resin in the most specific use of the term is a hydrocarbon secretion of many plants, particularly coniferous trees. Resins are valued for their chemical properties and associated uses, such as the production of varnishes, adhesives, and food glazing agents; as an important source of raw materials...
), forest workers, carpenters and cabinetmakers (wood dust), hairdressers (e.g. persulfate
Persulfate
The term persulfate refers to ions or compounds with more oxygen than normal sulfates.These do not have sulfur in a different oxidation state; rather, they contain peroxide units, where two oxygens take the place of one in a normal sulfate; the oxygen atoms are in oxidation state −1.The main forms...
), health care workers (latex and chemicals such as glutaraldehyde
Glutaraldehyde
Glutaraldehyde is an organic compound with the formula CH22. A pungent colorless oily liquid, glutaraldehyde is used to disinfect medical and dental equipment...
), janitors and cleaning staff (e.g. chloramine-T
Chloramine-T
Tosylchloramide or N-chloro tosylamide, sodium salt, sold as chloramine-T, is a N-chlorinated and N-deprotonated sulfonamide used as a biocide and a mild disinfectant. It is a white powder that gives unstable solutions with water...
), pharmaceutical workers (drugs, enzymes), seafood processors, shellac handlers (e.g. amines), solderers and refiners (metals), spray painters, insulation installers, plastics and foam industry workers (e.g. diisocyanates), textile workers (dyes) and users of plastics and epoxy resins (e.g. anhydrides)
Grains, flours, plants and gums |
|
|---|---|
Occupation |
Agent |
Bakers, millers |
Wheat |
Chemists, coffee bean baggers and handlers, gardeners, millers, oil industry workers, farmers |
Castor beans |
Cigarette factory workers |
Tobacco dust |
Drug manufacturers, mold makers in sweet factories, printers |
Gum acacia |
Farmers, grain handlers |
Grain dust |
Gum manufacturers, sweet makers |
Gum tragacanth Tragacanth Tragacanth is a natural gum obtained from the dried sap of several species of Middle Eastern legumes of the genus Astragalus, including A. adscendens, A. gummifer, A. brachycalyx, and A. tragacanthus. Some of these species are known collectively under the common names "goat's thorn" and "locoweed"... |
Strawberry growers |
Strawberry pollen |
Tea sifters and packers |
Tea dust |
Tobacco farmers |
Tobacco leaf |
Woollen industry workers |
Wool |
Animals, insects and fungi |
|
|---|---|
Occupation |
Agent |
Bird fanciers |
Avian proteins |
Cosmetic manufacturers |
Carmine Carmine Carmine , also called Crimson Lake, Cochineal, Natural Red #4, C.I. 75470, or E120, is a pigment of a bright-red color obtained from the aluminum salt of carminic acid, which is produced by some scale insects, such as the cochineal beetle and the Polish cochineal, and is used as a general term for... |
Entomologists |
Moths, butterflies |
Feather pluckers |
Feathers |
Field contact workers |
Cricket Cricket Cricket is a bat-and-ball game played between two teams of 11 players on an oval-shaped field, at the centre of which is a rectangular 22-yard long pitch. One team bats, trying to score as many runs as possible while the other team bowls and fields, trying to dismiss the batsmen and thus limit the... s |
Fish bait breeders |
Bee moths |
Flour mill workers, bakers, farm workers, grain handlers |
Grain storage mites, alternaria Alternaria Alternaria is a genus of ascomycete fungi. Alternaria species are known as major plant pathogens. They are also common allergens in humans, growing indoors and causing hay fever or hypersensitivity reactions that sometimes lead to asthma... , aspergillus Aspergillus Aspergillus is a genus consisting of several hundred mold species found in various climates worldwide. Aspergillus was first catalogued in 1729 by the Italian priest and biologist Pier Antonio Micheli... |
Laboratory workers |
Locusts, cockroach Cockroach Cockroaches are insects of the order Blattaria or Blattodea, of which about 30 species out of 4,500 total are associated with human habitations... es, grain weevils, rats, mice, guinea pigs, rabbits |
Mushroom cultivators |
Mushroom spores |
Oyster farmers |
Sea pineapple Sea pineapple The sea pineapple is an edible ascidian consumed primarily in Korea, where it is known as meongge , and to a lesser extent in Japan, where it is known as or .... s (Hoya) |
Pea sorters |
Mexican bean weevils |
Pigeon breeders |
Pigeons |
Poultry workers |
Chickens |
Prawn processors |
Prawn Prawn Prawns are decapod crustaceans of the sub-order Dendrobranchiata. There are 540 extant species, in seven families, and a fossil record extending back to the Devonian... s |
Silkworm sericulturers |
Silkworms |
Zoological museum curators |
Beetle Beetle Coleoptera is an order of insects commonly called beetles. The word "coleoptera" is from the Greek , koleos, "sheath"; and , pteron, "wing", thus "sheathed wing". Coleoptera contains more species than any other order, constituting almost 25% of all known life-forms... s |
Chemicals/Materials |
|
|---|---|
Occupation |
Agent |
Aircraft fitters |
Triethyltetramine |
Aluminum cable solderers |
Aminoethylethanolamine Aminoethylethanolamine Aminoethylethanolamine or AEEA is an organic base used in the industrial manufacture of fuel and oil additives, chelating agents and surfactants, among other things.... |
Aluminum pot room workers |
Fluorine Fluorine Fluorine is the chemical element with atomic number 9, represented by the symbol F. It is the lightest element of the halogen column of the periodic table and has a single stable isotope, fluorine-19. At standard pressure and temperature, fluorine is a pale yellow gas composed of diatomic... |
Autobody workers |
Acrylates (resins, glue Glue This is a list of various types of glue. Historically, the term "glue" only referred to protein colloids prepared from animal flesh. The meaning has been extended to refer to any fluid adhesive.... s, sealant Sealant A sealant may be viscous material that has little or no flow characteristics and stay where they are applied or thin and runny so as to allow it to penetrate the substrate by means of capillary reaction... s, adhesive Adhesive An adhesive, or glue, is a mixture in a liquid or semi-liquid state that adheres or bonds items together. Adhesives may come from either natural or synthetic sources. The types of materials that can be bonded are vast but they are especially useful for bonding thin materials... s) |
Brewery workers |
Chloramine-T Chloramine-T Tosylchloramide or N-chloro tosylamide, sodium salt, sold as chloramine-T, is a N-chlorinated and N-deprotonated sulfonamide used as a biocide and a mild disinfectant. It is a white powder that gives unstable solutions with water... |
Chemical plant workers, pulp mill workers |
Chlorine Chlorine Chlorine is the chemical element with atomic number 17 and symbol Cl. It is the second lightest halogen, found in the periodic table in group 17. The element forms diatomic molecules under standard conditions, called dichlorine... |
Dye weighers |
Levafix brilliant yellow, drimarene brilliant yellow and blue, cibachrome brilliant scarlet |
Electronics workers |
Colophony |
Epoxy resin manufacturers |
Tetrachlorophthalic anhydride |
Foundry mold makers |
Furan Furan Furan is a heterocyclic organic compound, consisting of a five-membered aromatic ring with four carbon atoms and one oxygen. The class of compounds containing such rings are also referred to as furans.... -based resin binder systems |
Fur dyers |
Para-phenylenediamine |
Hairdressers |
Persulphate salts |
Health care workers |
Glutaraldehyde Glutaraldehyde Glutaraldehyde is an organic compound with the formula CH22. A pungent colorless oily liquid, glutaraldehyde is used to disinfect medical and dental equipment... , latex Latex Latex is the stable dispersion of polymer microparticles in an aqueous medium. Latexes may be natural or synthetic.Latex as found in nature is a milky fluid found in 10% of all flowering plants . It is a complex emulsion consisting of proteins, alkaloids, starches, sugars, oils, tannins, resins,... |
Laboratory workers, nurses, phenolic resin molders |
Formaldehyde Formaldehyde Formaldehyde is an organic compound with the formula CH2O. It is the simplest aldehyde, hence its systematic name methanal.Formaldehyde is a colorless gas with a characteristic pungent odor. It is an important precursor to many other chemical compounds, especially for polymers... |
Meat wrappers |
Polyvinyl chloride Polyvinyl chloride Polyvinyl chloride, commonly abbreviated PVC, is a thermoplastic polymer. It is a vinyl polymer constructed of repeating vinyl groups having one hydrogen replaced by chloride. Polyvinyl chloride is the third most widely produced plastic, after polyethylene and polypropylene. PVC is widely used in... vapour |
Paint manufacturers, plastic molders, tool setters |
Phthalic anhydride Phthalic anhydride Phthalic anhydride is the organic compound with the formula C6H42O. It is the anhydride of phthalic acid. This colourless solid is an important industrial chemical, especially for the large-scale production of plasticizers for plastics. In 2002, approximately 4.6 billion kilograms were... |
Paint sprayers |
Dimethylethanolamine Dimethylethanolamine Dimethylaminoethanol, also known as DMAE or dimethylethanolamine, is an organic compound. This compound also goes by the names of N,N-dimethyl-2-aminoethanol, beta-dimethylaminoethyl alcohol, beta-hydroxyethyldimethylamine and Deanol. It is a clear, pale-yellow liquid.- Industrial uses... |
Photographic workers, shellac Shellac Shellac is a resin secreted by the female lac bug, on trees in the forests of India and Thailand. It is processed and sold as dry flakes , which are dissolved in ethyl alcohol to make liquid shellac, which is used as a brush-on colorant, food glaze and wood finish... manufacturers |
Ethylenediamine |
Refrigeration industry workers |
CFCs |
Solderers |
Polyether alcohol, polypropylene glycol Polypropylene glycol Polypropylene glycol or polypropylene oxide is the polymer of propylene glycol. Chemically it is a polyether. The term polypropylene glycol or PPG is reserved for low to medium range molar mass polymer when the nature of the end-group, which is usually a hydroxyl group, still matters... |
Isocyanates and metals |
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Occupation |
Agent |
Boat builders, foam manufacturers, office workers, plastics factory workers, refrigerator manufacturers, TDI Toluene diisocyanate Toluene diisocyanate is an aromatic diisocyanate. It is produced for reaction with polyols to form polyurethanes. It exists in two isomers, 2,4-TDI and 2,6-TDI . 2,4-TDI is produced in the pure state, but TDI is often marketed as 80/20 and 65/35 mixtures of the 2,4 and 2,6 isomers respectively... manufacturers/users, printers, laminators, tinners, toy makers |
TDI Toluene diisocyanate Toluene diisocyanate is an aromatic diisocyanate. It is produced for reaction with polyols to form polyurethanes. It exists in two isomers, 2,4-TDI and 2,6-TDI . 2,4-TDI is produced in the pure state, but TDI is often marketed as 80/20 and 65/35 mixtures of the 2,4 and 2,6 isomers respectively... |
Boiler cleaners, gas turbine cleaners |
Vanadium Vanadium Vanadium is a chemical element with the symbol V and atomic number 23. It is a hard, silvery gray, ductile and malleable transition metal. The formation of an oxide layer stabilizes the metal against oxidation. The element is found only in chemically combined form in nature... |
Car sprayers |
Hexamethylene diisocyanate Hexamethylene diisocyanate Hexamethylene diisocyanate is an organic compound in the class known as isocyanates. More specifically, it is an aliphatic diisocyanate. It is produced in relatively small quantities, accounting for only 3.4% of the global diisocyanate market in the year 2000... |
Cement workers |
Potassium dichromate |
Chrome platers, chrome polishers |
Sodium bichromate, chromic acid Chromic acid The term chromic acid is usually used for a mixture made by adding concentrated sulfuric acid to a dichromate, which may contain a variety of compounds, including solid chromium trioxide. This kind of chromic acid may be used as a cleaning mixture for glass. Chromic acid may also refer to the... , potassium chromate Potassium chromate Potassium chromate is a yellow chemical indicator used for identifying concentrations of chloride ions in a salt solution with silver nitrate... |
Nickel platers |
Nickel sulphate |
Platinum chemists |
Chloroplatinic acid |
Platinum refiners |
Platinum salts |
Polyurethane foam manufacturers, printers, laminators |
Diphenylmethane diisocyanate |
Rubber workers |
Naphthalene diisocyanate |
Tungsten carbide grinders |
Cobalt Cobalt Cobalt is a chemical element with symbol Co and atomic number 27. It is found naturally only in chemically combined form. The free element, produced by reductive smelting, is a hard, lustrous, silver-gray metal.... |
Welders |
Stainless steel Stainless steel In metallurgy, stainless steel, also known as inox steel or inox from French "inoxydable", is defined as a steel alloy with a minimum of 10.5 or 11% chromium content by mass.... fumes |
Drugs and enzymes |
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Occupation |
Agent |
Ampicillin manufacturers |
Phenylglycine acid chloride |
Detergent manufacturers |
Bacillus subtilis Bacillus subtilis Bacillus subtilis, known also as the hay bacillus or grass bacillus, is a Gram-positive, catalase-positive bacterium commonly found in soil. A member of the genus Bacillus, B. subtilis is rod-shaped, and has the ability to form a tough, protective endospore, allowing the organism to tolerate... |
Enzyme manufacturers |
Fungal alpha-amylase Alpha-Amylase α-Amylase is an enzyme that hydrolyses alpha-bonds of large alpha-linked polysaccharides such as starch and glycogen, yielding glucose and maltose. It is the major form of amylase found in humans and other mammals... |
Food technologists, laboratory workers |
Papain Papain Papain, also known as papaya proteinase I, is a cysteine protease enzyme present in papaya and mountain papaya .-Papain family:... |
Pharmacists |
Gentian powder, flaviastase |
Pharmaceutical workers |
Methyldopa Methyldopa Methyldopa is an alpha-adrenergic agonist psychoactive drug used as a sympatholytic or antihypertensive. Its use is now mostly deprecated following the introduction of alternative safer classes of agents... , salbutamol Salbutamol Salbutamol or albuterol is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease. It is marketed as Ventolin among other brand names.... , dichloramine Dichloramine Dichloramine is a reactive inorganic compound. It has the formula . The yellow gas is unstable and reacts with many materials. It is formed by a reaction between ammonia and chlorine or sodium hypochlorite... , piperazine dihydrochloride, spiramycin Spiramycin Spiramycin is a macrolide antibiotic. It is used to treat toxoplasmosis. Although used in Europe, Canada and Mexico, spiramycin is still considered an experimental drug in the United States, but can sometimes be obtained by special permission from the FDA for toxoplasmosis in the first trimester of... , penicillin Penicillin Penicillin is a group of antibiotics derived from Penicillium fungi. They include penicillin G, procaine penicillin, benzathine penicillin, and penicillin V.... s, sulphathiazole, sulphonechloramides, chloramine-T Chloramine-T Tosylchloramide or N-chloro tosylamide, sodium salt, sold as chloramine-T, is a N-chlorinated and N-deprotonated sulfonamide used as a biocide and a mild disinfectant. It is a white powder that gives unstable solutions with water... , phosdrin, pancreatic extracts |
Poultry workers |
Amprolium hydrochloride |
Process workers, plastic polymer production workers |
Trypsin Trypsin Trypsin is a serine protease found in the digestive system of many vertebrates, where it hydrolyses proteins. Trypsin is produced in the pancreas as the inactive proenzyme trypsinogen. Trypsin cleaves peptide chains mainly at the carboxyl side of the amino acids lysine or arginine, except when... , bromelin |
Woods |
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Occupation |
Agent |
Carpenters, timber millers, woodworkers |
Western red cedar, cedar of Lebanon, iroko, California redwood, ramin Ramin Gonystylus, also known as ramin, is a genus of about 30 species of hardwood trees native to southeast Asia, in Malaysia, Singapore, Indonesia, Brunei, the Philippines, and Papua New Guinea, with the highest species diversity on Borneo... , African zebrawood |
Sawmill workers, pattern makers |
Mansonia, oak Oak An oak is a tree or shrub in the genus Quercus , of which about 600 species exist. "Oak" may also appear in the names of species in related genera, notably Lithocarpus... , mahogany Mahogany The name mahogany is used when referring to numerous varieties of dark-colored hardwood. It is a native American word originally used for the wood of the species Swietenia mahagoni, known as West Indian or Cuban mahogany.... , abiruana |
Wood finishers |
Cocabolla |
Wood machinists |
Kejaat |
See also
- AsthmaAsthmaAsthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
- Chronic obstructive pulmonary diseaseChronic obstructive pulmonary diseaseChronic obstructive pulmonary disease , also known as chronic obstructive lung disease , chronic obstructive airway disease , chronic airflow limitation and chronic obstructive respiratory disease , is the co-occurrence of chronic bronchitis and emphysema, a pair of commonly co-existing diseases...
(COPD) - Specific inhalation challengeSpecific inhalation challengeThe Specific Inhalation Challenge is defined as a diagnosis toolto assess airway responsiveness to "sensitizing" substances as opposed tononspecific stimuli such as pharmacological agents ,cold air and exercise....
External links
- Asthma in the Workplace — For any questions on occupational asthma
- Canadian Lung Association — For all you need to know about Lung diseases, including occupational respiratory diseases
- SCL Medtech — For any questions on workplace asthma diagnosis, especially Specific Inhalation Challenge
- http://www.asthma.org.uk/all_about_asthma/asthma_at_work/occupational.html
- Occupational Asthma (UK) — Created by some of the most important people in the field, in UK. For any questions/ help on Workplace asthma
- National Institute for Occupational Safety and Health — Asthma and Allergies Page