Asthma, occupational

Category

Airway Disease

Acute/Chronic

Chronic

Synonyms

Occupational Asthma (OA);

Biomedical References

Comments

Immunologic asthma develops after a variable period of time during which sensitization to an agent present in the workplace takes place. Immunologic asthma can be classified as that caused by high-molecular or low-molecular weight compounds. To make the diagnosis of occupational asthma (OA), one must first confirm the presence of airway hyperreactivity. [Sullivan, p. 218] "Occupational asthma is a disease characterized by variable airflow limitation and/or hyperresponsiveness and/or inflammation due to causes and conditions attributable to a particular occupational environment and not to stimuli encountered outside the workplace." The two types of OA are: 1.) After a latency (allergic); and 2.) Without a latency period (nonallergic). The second type includes irritant induced asthma or RADS, which follows single or multiple exposures to "nonspecific irritants at high concentrations." [Asthma in the Workplace, p. 4-5] In Norway from 1995-1999, an average of 223 annual cases were reported with the highest incidence in the primary aluminum industry, and in bakers, car painters, and welders. [PMID 16142736] In the UK, about half of all new cases are caused by isocyanates, flour/grain, glutaraldehyde, solder/colophony, laboratory animals, resins/glues, and latex. [PMID 14504356] In 1993-1997 surveillance data from California, Massachusetts, Michigan, and New Jersey, 16% of cases were health-care workers, many of them nurses, with cleaning products, latex, and poor air quality the most frequently reported exposures. In the updated report for 1993-2000, 9% of work-related asthma cases were reported in educational services due to indoor air pollutants, unspecified mold, dusts, and cleaning products. [PMID 15712261]; [PMID 18033692] OA decreased in the West Midlands, UK between 1991 and 2011.associated with preventive activities to raise awareness of isocyanate exposure in motor vehicle repair body shops and to substitute nitrile for latex gloves, non-colophony for colophony soldering fluxes, and other disinfectants for glutaraldehyde in cold sterilization. [PMID 25608805] From 2000 to 2012, incidence of OA was declining in most countries "consistent with a positive impact of European initiatives addressing the relevant exposures." [PMID 25575531] "Update of an occupational asthma-specific job exposure matrix to assess exposure to 30 specific agents." [PMID 29650699] "An increase of fractional exhaled nitric oxide after specific inhalation challenge is highly predictive of occupational asthma." [PMID 29850946] "A compendium of causative agents of occupational asthma." [PMID 23706060] See "Asthma, irritant induced."

Latency/Incubation

Months to years

Diagnostic

History; Pulmonary function test; Methacholine challenge test; Specific challenge test

ICD-9 Code

493.0

ICD-10 Code

J45.2

Reference Link

Symptoms/Findings

Symptoms/Findings associated with this disease:

• chest tightness
• cough
• dyspnea, acute
• dyspnea, exertional
• eosinophilia
• hyperinflation
• obstructive defect
• wheezing

Job Tasks

High risk job tasks associated with this disease:

• Add sulfites to food (potatoes, lobster, wine, apricots)
• Apply polyester paints to hot metal
• Arc weld stainless steel
• Assemble products using cyanoacrylate glues
• Care for birds (zookeepers)
• Develop color photographs with compounds containing amines
• Disinfect or sterilize medical equipment
• Dye fur with compounds containing amines
• Dye or bleach hair
• Electroplating (rhodium and palladium)
• Formulate, mold, or cure resins to produce advanced composite materials
• Galvanize metal
• Generate bioaerosols derived from milk, eggs, or animal serum
• Generate bioaerosols of animal-derived proteins
• Generate bioaerosols of aromatic herbs, raw beef, goat dander, cow bone dust, or pig (butcher)
• Generate bioaerosols of biological enzymes
• Generate bioaerosols of vegetable gums
• Generate bioaerosols processing seafood
• Generate flour dust
• Generate grain dust
• Generate gutta percha dust (dental hygienist)
• Generate insect-derived bioaerosols
• Generate latex dust in manufacturing latex products
• Generate latex dust using latex products
• Generate mists of metalworking fluids containing ethanolamines
• Generate plant bioaerosols processing or packing food products
• Generate plant-derived bioaerosols
• Generate plastic dusts or powders (Plexiglas or polyvinyl chloride)
• Generate psyllium dust
• Generate tooth enamel dust
• Grind, mix, or weigh dyes or apply dyes to textiles
• Handle flowers
• Handle laboratory animals
• Heat or machine chromium alloys
• Heat or machine cobalt alloys
• Heat or machine manganese alloys
• Heat plastics--polyvinyl chloride, polyethylene, or polypropylene
• Inhale algae in algae preparation (pharmacist) or sea water (thalassotherapist)
• Inhale aspergillus in bakery, beet sugar refinery, or biotechnology plant
• Inhale bioaerosols in the home, school, or office environment
• Inhale insect allergens in fish food or fish bait
• Inhale insect allergens in the laboratory
• Inhale mite allergens while farming or handling flour or grain
• Inhale moldy wood dust
• Inhale pollen from cauliflower or broccoli plants (horticulturist)
• Inhale Rhizopus nigricans in a coal mine
• Machine wood and inhale dust
• Make brushes from tampico fibers
• Make molds in foundry using MDI, furfuryl alcohol, or amine curing agents
• Manually "lay-up" reinforced polyester resins using styrene
• Manufacture cemented carbide materials or tools
• Manufacture chemicals
• Manufacture pesticides containing captafol
• Manufacture rosin core solder (colophony) and rubber tires (tall oil)
• Mix and apply bone adhesives
• Mix or pack pharmaceutical products
• Plate metal with chromium
• Plate metal with nickel
• Prepare fruit salad using a solution of enzymes (pectinase and glucanase)
• Produce nacre buttons from mollusc shells
• Produce silk (sericulture)
• Refine platinum
• Repeatedly inhale bioaerosols containing mold (asthmogenic)
• Repeatedly inhale bioaerosols of slime mold
• Repeatedly inhale dust of esparto grass
• Spray chlorothalonil or tetramethrin (pesticides)
• Spray epoxy or polyurethane paint, shellac, lacquer, or varnish
• Spray polyurethane foam insulation
• Use anhydride compounds to manufacture chemical products
• Use azodicarbonamide as additive to plastics and rubber
• Use cemented carbide materials or tools
• Use chloramine-T for cleaning or disinfecting
• Use chromates or dichromates in printing
• Use chromates or dichromates in tanning
• Use dental acrylate compounds
• Use diazonium salts to manufacture photocopy paper or polymers
• Use diisocyanates to manufacture polyurethane products
• Use dioctyl phthalate to make polyvinyl chloride (PVC)
• Use epoxy, isocyanate, or formaldehyde-resin adhesives, finishes, or sealants
• Use ethanolamines in cleaning products
• Use ethanolamines, henna, karaya, sericin, or eugenol as a hairdresser
• Use formaldehyde or glutaraldehyde to develop x-rays in darkroom
• Use hydroxylamine for de-inking in paper recycling
• Use manganese-containing welding rods
• Use methacrylates to apply artificial fingernails
• Use polyfunctional aziridine hardener in paints, varnishes, or other coatings
• Use solder containing colophony, zinc chloride, ethanolamine, or ammonium chloride flux
• Use tetrazene to manufacture detonators
• Use urea formaldehyde to manufacture resins or foams
• Weld mild steel
• Weld on metal painted with chlorinated polyester paint
• Work as cement floorer with exposure to chromate salts
• Work in indoor pool as lifeguard or swimming instructor
• Work in microwave popcorn plant that uses diacetyl for flavoring
• Work in potroom at aluminum smelter

Agents

Hazardous agents that cause the occupational disease:

• Asthma-inducing agents