[Excerpt] Occupational asthma is asthma due to work exposures. It can be caused by a specific workplace agent with a specific immune system response – the agent is called a sensitizer. It has been recommended that whenever an adult experiences new-onset asthma, occupational asthma should be suspected. The respiratory symptoms of occupational asthma include wheezing, shortness of breath, chest tightness, cough, and sputum production. While these are similar to asthma that is not work-related, these symptoms occur due to a work-related exposure

Brown, Nellie J

English

DigitalCommons@ILR

Cornell University ILR School 
DigitalCommons@ILR 
Manuals and User Guides ILR Collection 
1-31-2019 
Occupational Asthma or Work-Related Exacerbation of Asthma 
Nellie J. Brown 
Cornell University ILR School, njb7@cornell.edu 
Follow this and additional works at: https://digitalcommons.ilr.cornell.edu/manuals 
Thank you for downloading an article from DigitalCommons@ILR. 
Support this valuable resource today! 
This Article is brought to you for free and open access by the ILR Collection at DigitalCommons@ILR. It has been 
accepted for inclusion in Manuals and User Guides by an authorized administrator of DigitalCommons@ILR. For 
more information, please contact catherwood-dig@cornell.edu. 
If you have a disability and are having trouble accessing information on this website or need materials in an 
alternate format, contact web-accessibility@cornell.edu for assistance. 
Occupational Asthma or Work-Related Exacerbation of Asthma 
Abstract 
[Excerpt] Occupational asthma is asthma due to work exposures. It can be caused by a specific 
workplace agent with a specific immune system response – the agent is called a sensitizer. It has been 
recommended that whenever an adult experiences new-onset asthma, occupational asthma should be 
suspected. The respiratory symptoms of occupational asthma include wheezing, shortness of breath, 
chest tightness, cough, and sputum production. While these are similar to asthma that is not work-related, 
these symptoms occur due to a work-related exposure. 
Keywords 
occupational asthma, work-related exposures, immune system 
Comments 
Required Publisher Statement 
© Cornell University. Reprinted with permission. All rights reserved. 
Recommended Citation 
Brown, N. J. (2019). Occupational asthma or work-related exacerbation of asthma [Electronic version]. 
Ithaca, NY: Cornell University, Workplace Health and Safety Program. 
This article is available at DigitalCommons@ILR: https://digitalcommons.ilr.cornell.edu/manuals/21 
Occupational asthma or work-related exacerbation of asthma 
Nellie J. Brown, MS, CIH 
January 31, 2019 
 
Occupational asthma is asthma due to work exposures. It can be caused by a specific 
workplace agent with a specific immune system response – the agent is called a 
sensitizer. It has been recommended that whenever an adult experiences new-onset 
asthma, occupational asthma should be suspected. The respiratory symptoms of 
occupational asthma include wheezing, shortness of breath, chest tightness, cough, and 
sputum production. While these are similar to asthma that is not work-related, these 
symptoms occur due to a work-related exposure.  
 
How much exposure to a sensitizer is needed for a person to experience asthma 
symptoms?  
This can vary a great deal, both as to the amount of allergen needing to be inhaled to 
trigger the asthmatic attack or the amount of time the person has been doing the job 
with that exposure. For some sensitizers and workers, the symptoms may occur quickly 
upon the person’s first exposures to the sensitizer. For some exposures, symptoms may 
not appear until after a latency period – this time period could range from weeks to 
years after the first exposure. For example, 30 years’ exposure to flour may be needed 
for a baker to develop asthma. While the symptoms occur due to exposure at the job, 
symptoms may appear at the beginning of the work shift, toward its end, or even in the 
evening after working hours. Typically, on days away from work, a person will improve 
or have no symptoms at all. It is important to note that shiftwork disrupts circadian 
rhythm and, among its many adverse effects, may also affect asthma symptoms and/or 
the performance of asthma medications.  
 
What kinds of potential allergens could a person encounter at work?  
Workplace exposure could include airborne gases, vapors, aerosols, fumes, dusts, or 
fibers. Sensitizers could include chemicals that are very small (low-molecular-weight) or 
large (high-molecular-weight), as well as chemicals produced by living organisms or 
pieces of organisms. Below are some examples of allergens with their typical 
occupations. (Please note that this is not an exhaustive list.) 
 
EXAMPLES OF POTENTIAL 
ALLERGENS 
OCCUPATIONS 
Animal allergens, dander Farmers, persons who work with laboratory animals, veterinarians 
Plants Greenhouse workers, farmers, parks and forestry workers 
Natural rubber, latex Latex-glove makers and users (such as health care workers), makers 
and users of other latex products 
Molds, fungi Construction/demolition workers; remediators of flood/storm events 
or other water damage 
Cereals and grains  
Other foods (such as milk powder and egg 
powder)  
Farmers, grain workers, bakery workers 
Food-production workers, cooks 
Enzymes Laboratory workers, pharmaceutical workers, bakery workers, laundry 
workers 
Fish and crustaceans  Workers handling herring or snow crabs 
Diisocyanates (such as, toluene 
diisocyanate, hexamethylene diisocyanate, 
and methylene diphenyl diisocyanate) 
Makers of rigid or flexible polyurethane foam, installers of 
polyurethane foam insulation, urethane spray painters, those who 
work with urethane adhesives or urethane molds in foundries 
Acrylic monomers Chemical-industry workers, dental workers, cosmetologists or nail 
technicians applying artificial nails 
Wood dusts (such as, from red cedar and 
many exotic woods; olive, pine, and others) 
Carpenters, sawmill workers, forestry workers 
Complex platinum salts  
Other metal salts (such as nickel, 
chromium)  
Refinery workers, jewelry workers 
Metal-plating workers, welders of stainless steel 
 
Unfortunately, even several years after removal from exposure, approximately 70% of 
people with occupational asthma can still experience asthma symptoms. So, the best 
approach is to be diagnosed early, before the asthma becomes severe, and to identify 
the allergen and reduce/stop the exposure.  
 
How could exposure to a workplace sensitizer be reduced or stopped? 
Depending upon how the allergen is used or exposure occurs, reducing or stopping a 
workplace exposure could include: 
• using an alternative chemical to the allergen  
• changing from a dry to a wet process for dust control 
• using local exhaust ventilation to capture and remove or dilute the allergen 
• enclosing the work process to capture the allergen 
• using measures to decrease the likelihood of a chemical (or dust) leak or its 
impact  
• using respiratory protection 
• placement in a different job, away from the allergen 
 
Under the Americans with Disabilities Act (ADA), a worker can request that the 
employer accommodate his/her occupational asthma.  
The above examples for reducing or eliminating occupational exposure could be used 
for reasonable accommodation. Under the ADA, an employer may require that an 
individual not pose a “direct threat” to the health or safety of himself/herself or others. 
However, this must be a “significant risk of substantial harm” -- employers cannot deny 
an employment opportunity merely because of a slightly-increased risk.  Assessing 
“direct threat” must be strictly based on valid medical analyses and/or other objective 
evidence and must apply to all employees (and job applicants).  
 
But, a different standard of risk may be considered in those cases where risk to the 
public or other workers is present, as opposed to a risk limited to the worker. Each 
person must be evaluated as an individual -- different people experience asthma with 
differing responses as to how quickly or severely they are affected, as well as what an 
asthmatic reaction at work would entail. For example, is the person a clerical worker 
near good medical facilities, or a police officer, firefighter, or airline pilot during the 
performance of his/her professional duties? A medical evaluation needs to be specific, 
rather than a general statement such as the individual “may not be exposed to gases, 
mists, or fumes.” If a direct threat exists, the employer must first try to eliminate or 
reduce the risk to an acceptable level with reasonable accommodation. But, if an 
effective accommodation to a direct threat cannot be found, the employer may 
discharge an employee (or may refuse to hire a job applicant).  
 
What if a worker has asthma that is not caused by a workplace sensitizer? Sometimes 
a workplace exposure, such as an irritant, can trigger an episode of asthma for an 
employee with non-occupational asthma. Also, there are symptoms that mimic asthma, 
such as irritable larynx syndrome. So, even non–work-related asthma can affect the 
ability to work.  
 
The information in this fact sheet was originally developed for The Center for 
Occupational & Environmental Medicine at the Erie County Medical Center (ECMC), 462 
Grider St., Buffalo, NY 14215. The fact sheet is licenced under a Creative Commons 
Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0) licence.   
 
 
 


Occupational Asthma or Work-Related Exacerbation of Asthma

[Excerpt] Occupational asthma is asthma due to work exposures. It can be caused by a specific workplace agent with a specific immune system response – the agent is called a sensitizer. It has been recommended that whenever an adult experiences new-onset asthma, occupational asthma should be suspected. The respiratory symptoms of occupational asthma include wheezing, shortness of breath, chest tightness, cough, and sputum production. While these are similar to asthma that is not work-related, these symptoms occur due to a work-related exposure.Brown44_Occupational_asthma_article_as_pamphlet_01312019.pdf: 47 downloads, before Oct. 1, 2020

Brown, Nellie J.

eCommons (Cornell Univ.)

https://digitalcommons.ilr.cornell.edu/cgi/viewcontent.cgi?article=1025&amp;context=manuals

Occupational Asthma or Work-Related Exacerbation of Asthma

Abstract

Similar works

Full text

Available Versions

DigitalCommons@ILR

eCommons (Cornell Univ.)