Asthma is a disease that affects the lungs; the airways become narrow and inflamed. Symptoms can include:

• Episodes of wheezing
• Chest tightness
• Shortness of breath
• Coughing

Asthma can be controlled by taking medicine and avoiding triggers that can cause asthma symptoms.

Work-related Asthma

Work-related asthma is asthma triggered by an exposure at work. Many asthma triggers can be found in the workplace. Over 300 known or suspected substances in the workplace can cause or worsen asthma. Avoiding triggers can prevent asthma from getting worse.

Worsening asthma or new onset asthma in a worker should raise questions about workplace causes. Asthma symptoms can develop shortly after exposure, or they can develop months or years after repeated exposures to harmful substances.

Asthma is now the most common chronic disorder in childhood. In the U.S., nearly 24 million people have asthma. Asthma often occurs early in life, but it can also occur for the first time in adulthood. Some patients can also "outgrow" asthma at first, but then develop symptoms again later in life.

What is asthma?

Asthma is an inflammatory disease of the lung. It can occur along the entire airway from the nose to the lung. Once the airway becomes swollen and inflamed, it becomes narrower, and less air gets through to the lung tissue. The exact cause of asthma is not known. Researchers think some genetic and environmental factors interact to cause asthma, usually before the age of 5.

What are the symptoms of asthma?

Wheezing, coughing, chest tightness, and trouble breathing. During an asthma attack, the muscles around the airways tighten up, more mucus is produced, and asthma symptoms become worse.

Are allergies related to asthma?

Yes. Asthma can be triggered by substances in the environment called allergens. Some indoor allergens come from dust mites, cockroaches, dogs, cats, rodents, molds, and fungi. Outdoor allergens include pollen from many trees, weeds, and grass. Even food allergies can cause asthma symptoms.

What about air pollution outside?

Outdoor pollution plays a major role, as does cigarette smoke. Children exposed to pollution are more likely to develop asthma. Asthma patients are more likely to have their asthma flare up when they are exposed to pollution. This is why asthma patients should not exercise outdoors during high-pollution days, for example when there is a code-orange ozone day.

How is asthma treated?

Treatment plans can include taking prescribed medicine and avoiding your asthma triggers. You can breathe in some medicines and take other medicines as a pill. Asthma medicines come in two types—quick-relief and long-term control. Quick-relief medicines control the symptoms of an asthma attack. Long-term control medicines help you have fewer and milder attacks, but they don't help during an asthma attack.

Indoor Allergens & Asthma

What steps can you take to reduce indoor allergens and prevent asthma attacks?

• Vacuum carpets and upholstered furniture every week.
• Reduce humidity to under 50% and check for leaks/water damage to reduce mold.
• Eliminate pest infestations to reduce cockroach or mouse allergen exposure.
• Use HEPA air filtration devices to reduce airborne allergens. Change HVAC filters at least once every quarter, or more frequently if your home has a lot of dust.
• Wash sheets and blankets in hot water every week.
• Put mattresses, pillows, and box springs in allergen-proof covers.
• Limit dog and cat exposure in the home.

There are two main categories of work-related asthma: occupational asthma and work-exacerbated asthma (sometimes known as work-aggravated asthma). Occupational asthma describes asthma caused by worksite exposures. Work-exacerbated asthma describes existing asthma that worsens because of worksite exposures to irritants, allergens, or physical conditions. Work-related asthma that is not identified and managed early can get worse. Work-related asthma reduces productivity and quality of life.

Work-related asthma is associated with exposure to worksite irritants, allergens, and physical conditions called triggers. Some examples of asthma triggers are:

• Animal dander and insects
• Chlorine-based cleaning products
• Cigarette smoke
• Cockroach droppings
• Cold air
• Dust from wood, grain, flour, or green coffee beans
• Dust mites
• Gases such as ozone
• Indoor dampness and mold
• Irritant chemicals
• Metal dust
• Physical exertion
• Pollen and plants
• Strong fumes
• Vapors from chemicals (e.g., ammonia, isocyanates, and solvents)
• Wood smoke

The symptoms of work-related asthma are the same as symptoms for non-work-related asthma. They include:

• Wheezing
• Coughing
• Chest tightness
• Shortness of breath

Asthma symptoms can come and go, and some workers might not have all symptoms. Workers can get work-related asthma even when using personal protective equipment such as respirators or face masks. Sometimes, these breathing problems start at work and continue even after the worker leaves work and exposure has stopped.

Symptoms for work-related asthma tend to get better on weekends, vacations, or other times when away from work. However, in some cases, symptoms do not improve until an extended time away from the exposure or trigger.

Symptoms for work-related asthma tend to get better on weekends, vacations, or other times when away from work. However, in some cases, symptoms do not improve until an extended time away from the exposure or trigger.

Work-related asthma can be diagnosed by your doctor. Tell your doctor about work exposures and possible asthma triggers, including your job, tasks, and the materials you use. Also consider logging when and where your symptoms occur to help determine any patterns. Your doctor will ask you questions about your symptoms and will conduct a physical examination. The doctor might also order one or more of the following tests:

• Breathing tests (e.g., peak flow readings and spirometry)
• Allergy tests such as skin or blood tests

If your doctor is concerned about something other than asthma, he/she might order other tests such as x-rays or imaging tests.

The most important step of treating asthma is stopping or reducing exposure to the asthma triggers causing symptoms. You should work with your doctor to develop a personal asthma control plan. Asthma is often treated with two general types of medicine:

Quick-relief rescue inhalers (e.g., albuterol, levalbuterol) to open the airways. People use these medicines to treat asthma attacks or flare-ups.

Long-term control medicines to reduce inflammation in the airways. People use these medicines to help keep asthma symptoms from occurring. When these medicines are working well, quick relief medicine is not used as much.

The following guidelines can help employers and employees develop and maintain a worksite safe from asthma triggers. Minimizing exposure to work-related asthma triggers can help employees to be healthier.

Employers

The hierarchy of controls (image below) is an approach that groups actions by their likely effectiveness in removing or reducing hazards. The preferred approach includes the following:

• Eliminate or substitute hazardous processes or materials. When developing a project, take necessary precautions to prevent potentially harmful exposures and reduce the need for additional controls in the future.
• Install engineering controls to reduce exposure or shield employees. For example, isolate or enclose processes, and install local exhaust ventilation to capture exposures at the source.
• Implement administrative controls such as work practices or policies that reduce or prevent hazardous exposures.
• Train workers on potential workplace hazards, what precautions they should take to protect themselves, and workplace policies for reporting their concerns.
• Establish a no-smoking policy in the workplace. Tobacco smoke is a trigger for some people with asthma.

Some employers might want to consider establishing a medical surveillance plan to monitor for asthma through questionnaires and routine lung function testing (spirometry). A surveillance plan might identify workers with asthma at earlier stages of disease, when workers are more responsive to treatment.

Personal protective equipment (PPE) might also be needed. PPE is the least effective means of controlling hazardous exposures and should not be the sole method for controlling hazardous exposures. Rather, PPE should be used until effective engineering and administrative controls are in place. Proper use of PPE requires a comprehensive program and a high level of employee involvement and commitment. Additionally, the right personal protective equipment must be chosen for each hazard.

Employees

Employees should be attentive to their work environment, especially those with breathing problems. Follow the steps below if you feel you have work-related asthma symptoms.

• Identify and avoid exposures to asthma triggers.
• Participate in your employer’s asthma surveillance plan, if available.
• Report new or worsening breathing problems to your doctor and the designated person at your workplace.
• Immediately report if personal protective equipment or engineering controls malfunction to your supervisor.
• If you have asthma, take your medications as prescribed and regularly see your doctor.
• Get a flu shot every year.
• If you smoke, talk to your doctor or employer about resources to help you quit smoking.

What Is Asthma?

Asthma is a disease that affects your lungs. It is one of the most common long-term diseases of children, but adults can have asthma, too. Asthma causes wheezing, breathlessness, chest tightness, and coughing at night or early in the morning. If you have asthma, you have it all the time, but you will have asthma attacks only when something bothers your lungs.

We don’t know all the things that can cause asthma, but we do know that genetic, environmental, and occupational factors have been linked to developing asthma.

If someone in your immediate family has asthma, you are more likely to have it. “Atopy,” the genetic tendency to develop an allergic disease, can play a big part in developing allergic asthma. However, not all asthma is allergic asthma.

Being exposed to things in the environment, like mold or dampness, some allergens such as dust mites, and secondhand tobacco smoke have been linked to developing asthma. Air pollution and viral lung infection may also lead to asthma.

Occupational asthma occurs when someone who never had asthma develops it because he or she is exposed to something at work. This can happen if you develop an allergy to something at work such as mold or if you are exposed to irritants such as wood dust or chemicals at work over and over at lower levels or all at once at higher levels.

How Can You Tell if You Have Asthma?

It can be hard to tell if someone has asthma, especially in children under age 5. Having a doctor check how well your lungs work and check for allergies can help you find out if you have asthma.

During a checkup, a doctor will ask if you cough a lot, especially at night. He or she will also ask whether your breathing problems are worse after physical activity or at certain times of year. The doctor will then ask about chest tightness, wheezing, and colds lasting more than 10 days. He or she will ask whether anyone in your family has or has had asthma, allergies, or other breathing problems. Finally, the doctor will ask questions about your home and whether you have missed school or work or have trouble doing certain things.

The doctor may also do a breathing test, called spirometry, to find out how well your lungs are working by testing how much air you can breathe out after taking a very deep breath before and after you use asthma medicine.

What Is an Asthma Attack?

An asthma attack may include coughing, chest tightness, wheezing, and trouble breathing. The attack happens in your body’s airways, which are the paths that carry air to your lungs. As the air moves through your lungs, the airways become smaller, like the branches of a tree are smaller than the tree trunk. During an asthma attack, the sides of the airways in your lungs swell and the airways shrink. Less air gets in and out of your lungs, and mucous that your body makes clogs up the airways.

You can control your asthma by knowing the warning signs of an asthma attack, staying away from things that cause an attack, and following your doctor’s advice. When you control your asthma:

• you won’t have symptoms such as wheezing or coughing,
• you’ll sleep better,
• you won’t miss work or school,
• you can take part in all physical activities, and
• you won’t have to go to the hospital.

What Causes an Asthma Attack?

An asthma attack can happen when you are exposed to “asthma triggers.” Your asthma triggers can be very different from someone else’s asthma triggers. Know your triggers and learn how to avoid them. Watch out for an attack when you can’t avoid your triggers. Some of the most common triggers are tobacco smoke, dust mites, outdoor air pollution, cockroach allergen, pets, mold, smoke from burning wood or grass, and infections like flu.

How Is Asthma Treated?

Take your medicine exactly as your doctor tells you and stay away from things that can trigger an attack to control your asthma.

Everyone with asthma does not take the same medicine.

You can breathe in some medicines and take other medicines as a pill. Asthma medicines come in two types—quick-relief and long-term control. Quick-relief medicines control the symptoms of an asthma attack. If you need to use your quick-relief medicines more and more, visit your doctor to see if you need a different medicine. Long-term control medicines help you have fewer and milder attacks, but they don’t help you while you are having an asthma attack.

Asthma medicines can have side effects, but most side effects are mild and soon go away. Ask your doctor about the side effects of your medicines.

Remember – you can control your asthma. With your doctor’s help, make your own asthma action plan. Decide who should have a copy of your plan and where he or she should keep it. Take your long-term control medicine even when you don’t have symptoms.