OCCUPATIONAL ASTHMA

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Semran Rafiq Bhat

Occupational Asthma is a workplace related disease of airways that is characterized by increase response of the lungs to a variety of allergens which results in narrowing of air passages. When this condition is particularly caused by industrial triggers we call it Occupational or Industrial Asthma.

Occupational Asthma (Causes and How to avoid)

Chances of getting Occupational Asthma in factories and industries.

Occupational asthma is a type of asthma and if you are a factory worker there is 11% to 26% of chance that you will get Occupational Asthma.

How do you get Occupational Asthma?

When a factory worker exposes himself to below substance for a longer time:

1) Fumes.

2) Gases such as chlorine, Sulphur dioxide.

3) Chemicals used in making insulations, paints. adhesives, soaps etc.

4) Longtime exposure to metals like chromium ,platinum etc.

5) Latex gloves .

What symptoms you can feel if you have Occupational Asthma?

Shortness of breath, Cough, Sounds heard on breathing(Wheezing),chest tightness, runny nose, irritation of eyes which leads to watery eyes.

Changes in the lungs: Lung will be distended like balloon due because of over inflation .Bronchi and bronchioles are blocked by thick mucus.

On microscope lung shows, mucus contain normal or degenerative respiratory tissue forming twists of strips called Curschmann’s spirals. The sputum usually contains numerous eosinophils and diamond shaped crystals called Charcot-Leyden Crystals.

How to differentiate between Occupational asthma from other types?

Allergens other than occupational like pollen, dusts mites etc comes under intrinsic type of asthma and when the allergen is particularly associated with workplace we call it Occupational asthma. So, we conclude that occupational asthma is a sub type of intrinsic (allergic) asthma.

We can also inject suspected allergen into the skin and check whether the test comes out to be positive or negative if positive (IgE levels increase if test is positive) we say patient is asthmatic.

How allergen causes occupational Asthma?

First phase(Acute phase): Allergen enters the lungs which activates the mast cells ,these cells release substances like histamine ,leukotrienes,prostaglandins,platelet activating factor and chemotactic factors for eosinophils and neutrophils.These substances narrows the lungs,causes swelling,causes increase in mucus secretion and accumulates eosinophils and neutrophils .

Second phase (Late phase): Responsible for long term symptoms of asthma .Excessive mobilisation of blood leucocytes which includes basophils besides eosinophils and neutrophils is the cause of this phase .These result in further release of substances which facilitate the above mentioned effects.

Which tests we need in occupational Asthma?

Physical examination where doctor list downs all the workplace irritants that can lead to this condition. And then start doing the laboratory tests.

Allergy test (IgE test).

Spirometry to measure lung capacity. In this test we measure the amount of air lungs can breath in and breath out.

Peak flow meter test.

Chest X-ray normal but lobar collapse appears if mucus occludes a large bronchi.

How you can prevent yourself from getting occupational asthma?

Identify the allergens which can cause inflammation.

Remove or reduce the workplace causative factors so that workers health is not affected.

Replace the irritant with less harmful substance.

•Develop worksite that is free from allergens.

Install engineering controls and exhaust ventilation to protect workers such as isolating the processes.

Use of personal protective equipment by factory workers.

Use face masks to cover your airways completely so that not a tiny amount of allergen can enter your lungs.

Minimize the exposure time of worker to a substances because long exposures lead to this condition.

Aware the factory workers about allergens and there consequences on their health so that they can take precautionary measures.

Educate the worker about the proper use of masks gloves and PPE’s.

Which medicines we can take in Occupational Asthma?

Occasional use of inhalers which contain SABA (short-acting beta-2 adrenergic receptor agonist bronchodilator)

Use inhalers which contain glucocorticoids (ICS) such as beclometasone, budesonide, fluticasone.

How does Occupational Asthma effects industries and factories?

Asthmatic patient who is allergic to certain types of substances at his or her workplace cannot work for longer times as these allergen can worsen his health and can prove to be fatal.Moreover,people suffering from occupational asthma are mentally as well as physically tired,weak,stressed and can’t focus properly on their work.So there is decrease in the number of workers by 10%-20% every year which results in the decrease in the productivity which ultimately reduces the annual economy of the country. So it’s necessary for the workers to take necessary precautionary measure to save themselves as well as country’s economy.

Organizations working on Occupational health all over the world.

In India there are a lot of organizations that focus on occupational safety and health. These include :

The National Institute of Occupational health(NIOH)– Established on 1970.It works on workplace stress, environmental stress etc.

The National Safety Council of India(NSCI)– It includes awareness programmes about preventing diseases. NSCI works on 3 main principles:

a) Safety of health in transportation.

b)Safety of health in construction sector.

c)Safety of health in enterprises.

Indian Association of Occupational health.

Central Labor Institute and many more.

Other than India there are agencies that are globally working on it like :

California Division of Occupational health and safety.

Canadian center for Occupational health and safety.

The main objective of all these organizations include occupational safety and health, maintenance and promotion of health of workers, working capacity of a worker, inspection of workplace conditions and environment.

Health and safety laws for factory workers:

There are various laws that ensure the health and safety of a factory worker:

1) It’s necessary to keep every factory clean and get rid of the source that can cause irritation to the factory workers.

2) Disposing the sewage in a proper way so that it cannot lead to various chemical borne diseases.

3) Dust, fumes and toxic gases are produced in majority of factories, in order to ensure the proper health of a factory worker, administration should provide workers with respiratory masks and other safety equipment.

4) Its not allowed for a worker to work for more than 48 hours in a week as the exposure to certain harmful substances for a longer time can lead to respiratory disorder.

Article 42 : Includes humane conditions at work and it also provide maternity relief. This law was established on 23 November 1948.

Moreover the world health assembly also directs various countries to intervene in various programs that are related to prevention and control of occupational and workplace related diseases, promotion of health facilities etc. The Ministry Of Health And Family Welfare, GoI introduced “National Programme For Control And Treatment Of Occupational Diseases” in the year 1998 to1999.