Asthma is a very common disease in adults, including in those who work outside the home. Work-related asthma refers to asthma that is either caused by or worsened by something at work. It is very important to know whether someone has work-related asthma because there are specific ways to manage it. There are two types of work-related asthma: occupational asthma and work-exacerbated asthma.

• Occupational asthma is when something at work causes you to have new onset asthma.
• Work-exacerbated asthma means the asthma you already have been diagnosed with is being made worse from something at work. Typically this occurs when substances present in that workplace trigger asthma symptoms.

This page has information about work-exacerbated asthma.

Who gets work-exacerbated asthma?

Any person with a diagnosis of asthma who works can get work-exacerbated asthma. For example, teachers, healthcare workers, cleaning staff, office workers, animal handlers, as well as workers in more industrial "dirty" workplaces, such as construction workers, factory workers, painters, firefighters, carpenters, and welders are exposed to substances or conditions that can cause work-related asthma. Find more information on asthma and on other work related lung diseases.

How common is Work-Exacerbated Asthma?

Work-exacerbated asthma is very common. About 25% to up to 50% of working adults with known asthma have exacerbations with asthma symptoms related to their workplace. These symptoms include wheezing, cough, chest tightness and/or shortness of breath.

What causes work-exacerbated asthma?

A number of substances and conditions in the workplace can trigger your asthma symptoms. These triggers include irritants, allergens, extreme temperatures, humidity, and physical exertion. Irritants such as cleaning products, bleach, smoke, fumes, and dusts can worsen asthma symptoms.

Exposure to allergens in your workplace that you are sensitive to can also trigger your asthma symptoms, such as molds, dust mites, dander from animals, and pollens from trees, weeds, and grasses. Poor ventilation (fresh air exchange) in the workplace can increase the amount of exposure you get to indoor pollutants and triggers.

Why Do I Need To Find Out If I Have Work-Exacerbated Asthma?

Work-Exacerbated Asthma can make your asthma more severe and harder to control. Having uncontrolled work-exacerbated asthma may mean you can no longer work at your job and this can lead to being unemployed. Knowing what causes your work-exacerbated asthma and reducing factors at work that make your asthma worse, can lead to better asthma control, quality of life and being able to stay on the job.

Usually the sooner your problem of work-exacerbated asthma is diagnosed, the easier it is to control. Also, some substances in the workplace (such as cleaning products, mold, or fumes) that worsen your asthma may affect others in your workplace with asthma. Therefore, recognizing these problems may help your coworkers as well.

How Do I Know If I Have Work-Exacerbated Asthma?

Several clues can lead you to suspect work-exacerbated asthma. If your asthma has gotten worse after a new job or a change in your workplace, you should suspect work-exacerbated asthma. If your asthma symptoms are worse when at work and/or improve when you are away from work (such as on weekends or holidays), you may have work-exacerbated asthma.

You may also notice other symptoms related to being at work, such as runny nose, eye or throat irritation, or a skin rash. Symptoms may continue even after you end your workday. You may find you need to use your rescue inhaler such as albuterol or levalbuterol more at or after being at work.

How Is Work-Exacerbated Asthma Diagnosed?

If you work and your asthma symptoms have worsened and/or you are using your asthma rescue inhaler more frequently, it is important that you tell your healthcare provider about your work and asthma symptoms. You should tell your healthcare provider what kind of work you do, how long you have been working there, and whether there have been any changes in your workplace, such as construction, renovations, water damage, or the use of new products. You should also tell your healthcare provider if your asthma symptoms worsen at work and/or improve away from work, and if you suspect that some particular substance(s), location, or activity at work is making your asthma worse.

Your healthcare provider may give you a peak flow meter and diary to measure and record your breathing and asthma symptoms.You should also record whether or not you are at work, and when you use your rescue inhaler.

You can get more information about substances you work with that you think may be a problem by asking for a copy of the Safety Data Sheets (SDS) from your employer.

How Is Work-Exacerbated Asthma Managed?

If your healthcare provider suspects work-related asthma, it is important that changes are made to reduce asthma triggers at your work. Your healthcare provider will work with you to make any changes in your asthma medicine to try to improve your asthma care. Changes that can reduce workplace triggers include:

• improving the ventilation (fresh air exchange),
• using less irritating substances,
• fixing water leaks,
• changing your work assignment,
• or wearing a protective mask for certain tasks.

In the United States, the national US Americans with Disabilities Act (ADA) states that employers have a legal obligation to try to make "reasonable accommodation" for their employees. That means employers must make adjustments to the workplace in order to keep someone employed, unless the changes would be "unreasonable." If you have problems with your employer not helping to address your exposure concern, you can file a complaint to the US Department of Justice. Workers should also be counseled about their rights and benefits, including workers’ compensation benefits.

Adapted from American Thoracic Society, PATIENT EDUCATION|INFORMATION SERIES worksheet Work-exacerbated Asthma.