Asthma and Adult

Asthma is often thought of as a condition you get when you're a child, and for many, asthma does start in childhood. However, people can be diagnosed with asthma for the first time when they're adults, causing additional impact to their lives. This is known as 'adult onset asthma'.

In older people, the symptoms of asthma are less likely to be triggered by allergies such as house-dust mites, animals and pollen.

Symptoms in adults are more likely to be triggered by:

• flu, colds or other viral infections.
• exercise.
• laughing or getting excited.
• depression or anxiety.
• some medicines.
• irritants such as cigarette smoke, cold air, perfumes and chemical fumes.

For older people, shortness of breath may be the only symptom. However, it can be difficult to tell the difference between asthma and other conditions that cause similar symptoms, such as bronchitis, emphysema, heart disease and chronic obstructive pulmonary disease (COPD), so it's sometimes difficult to diagnose asthma in older adults.

What is occupational asthma?

Occupational asthma is caused directly by work and is usually the result of a reaction that can occur in some people when they are exposed to certain substances known as respiratory sensitisers. These are inhaled into the lungs over a period of time and cause asthma symptoms. Occupational asthma can be a serious condition leading to severe chronic asthma if exposure to respiratory sensitiser continues.

The condition can take weeks, months or even years to develop, depending on the person and the substance.

If you think your asthma has been caused by something at work, look out for these symptoms:

• your asthma symptoms are worse during the working week, at work or after work
• your symptoms may get worse after work, or you may find your sleep is disturbed during the night
• your symptoms improve when you have been away from work for several days (eg when you are on holiday)
• you may have other associated nasal conditions such as rhinitis, (sneezing, itchy, runny nose) or conjunctivitis (itchy, red, and inflamed eyes).

Which substances cause occupational asthma?

Substances that can cause occupational asthma are called respiratory sensitisers. Below is a list of some of the main ones and the jobs where you are most likely to come across them.

• Chemicals called isocyanates are the most common cause of occupational asthma in theUK. There are many jobs in which you might be exposed to these chemicals, particularly spray painting, foam moulding using adhesives, and making foundry cores and surface coatings.
• Dust from flour and grain (pictured). This will affect people who work in bakeries, industrial baking, farm work and grain transport.
• Wood dust, particularly from hard wood dusts and western red cedar. This will affect people working in carpentry, joinery and sawmilling.
• Colophony - this is widely present in soldering fumes but also in glues and some floor cleaners, and may affect people in the electronics industry, welding industry.
• Dust from latex rubber. This will affect people working with latex gloves, such as nursing, dentistry or laboratory technicians.
• Dust from insects and animals, and from products containing them. This may impact people doing laboratory work, farm work or work with shellfish.

How can I prevent occupational asthma?

You can prevent occupational asthma by avoiding exposure to respiratory sensitisers. To achieve this you should follow these steps:

• If you're diagnosed with occupational asthma, you should avoid or reduce exposure to the substance as soon as possible.
• Try to get any respiratory sensitisers in your workplace removed or replaced with a safe alternative. If this is not possible, your employer can reduce the risk by installing extractor fans or isolating you from the process that produces the risk.
• If these steps aren't possible, use personal protective equipment such as breathing equipment, which will prevent you from inhaling the respiratory sensitiser.

What if I think I have occupational asthma?

See your doctor straight away. If they suspect that you do have occupational asthma, they should refer you to a Respiratory Specialist with a special interest in occupational asthma. If occupational asthma is confirmed, your doctor should, with your consent, advise your employer to relocate you away from the respiratory sensitiser.

Diagnosis of occupational asthma doesn't always mean you have to leave your job. Talk to your employer and health and safety representative about other options available to you. However, if you feel leaving work is the only option; you may want to investigate if you are eligible to make a claim for compensation.

How is occupational asthma diagnosed?

Occupational asthma may be diagnosed in the following cases:

• Your asthma is worse during the working week, though not necessarily at work itself or your symptoms get worse after work, or you find your sleep is disturbed during the night.
• Your symptoms may improve when you have been away from work for several days or on holiday.

Your doctor should take a full medical history and work history around your symptoms. They may ask you to record keep a peak flow diary  at home and at work.

If occupational asthma is suspected, you should be referred to an occupational respiratory specialist for confirmation of diagnosis.

How soon should I start to avoid contact with the respiratory sensitiser?

It is important to avoid the respiratory sensitiser as soon as possible. Even inhaling tiny amounts may be enough to trigger your asthma. Once you avoid all contact with the respiratory sensitiser you're likely to feel much better than you have done for some time.

Will I need to stop working?

Although it is important that you avoid coming in contact with the respiratory sensitiser, it may be possible -with the right protection- to carry on working in your current job for the short term. In the longer term, you will need to talk to your employer (and if you have one, you occupational health doctor or nurse) to see if changes can be made to your current job to make it safer for you, or if you can be given another role.  Most employers will try to help you in these ways.

If your employer can't find you safe work you may need to seek another job.

Having occupational asthma does not make you unfit to work-it just means you need to avoid jobs which involve exposure to the allergen that causes your asthma.

Will I always have occupational asthma?

The respiratory sensitiser that causes your occupational asthma will always be a trigger for you. However, most people who avoid contact with their trigger recover very well. Sometimes recovery happens as soon as contact with the trigger stops. Sometimes it can take longer- this is often the case if you had occupational asthma for a while and so have more serious symptoms. If your asthma symptoms are severe and you've had them for some time they may not go away completely.

Although your asthma has been caused by exposure to a respiratory sensitiser in your work place, your asthma symptoms should be treated and managed in the same way as anyone with asthma.