October 20, 2014

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Reducing occupational asthma: knowledge is key


Asthma is a common breathing problem, of global concern. Everyday, my clinical practice confirms this. While patients tell us that their inhaled treatments have improved vastly over the last 20 years, asthma continues to cause ill health in a large proportion of the population.

One global initiative, GINA, estimates that seven per cent of the adult population suffer from this condition; that causes chest tightness, wheezing and difficulty in breathing in a significant number of its sufferers. This is not a minor or rare problem, and it is easy to understand how these complaints can increase absence from work, increase presenteeism and reduce workplace productivity.

The relationship between asthma and the workplace is interesting and has been appreciated for at least 200 years. Inhaled exposures at work, for example, are known to cause asthma. One in 6 cases of adult onset asthma are caused by workplace exposures. Typically in the UK, these exposures include:

  • flour dust
  • cleaning agents
  • isocyanate containing paint systems
  • wood dusts
  • animal and insect material, and
  • metal working fluids.

These exposures, and many more, can lead to the development of asthma over a period of time if a worker is not adequately protected. Whilst these are the commonest causes, other rarer and more novel exposures are also known to cause asthma. These include beautician work, hairdressing agents, seafood exposures and certain types of welding.

Many more workers with asthma complain that when they go to work their asthma symptoms get worse. This is because their breathing tubes are sensitive to inhaling many different types of vapours, gases, dusts and fumes.

So how can simple measures at work help to reduce these problems?

My personal view is that the “traditional” approach is, of course, key. A good knowledge of the types of work tasks that are associated with exposures that cause asthma will help all with responsibility for risk assessments to carry these out more effectively. There is good advice and information available on the HSE website about the content of these exposures and the prevention of the condition. In addition, periodic health checks or health surveillance may be appropriate to help spot workers with early signs of asthma.

I believe that a “more modern” approach should also be developed, as the world of health is ever changing. It should also now be acceptable to openly talk about these issues at work with affected, and, at risk workers. Strong leadership will enable such caring approaches to reduce the burden of this very unpleasant illness. A culture change is needed; from one where health is not mentioned or considered and regarded only as the responsibility of doctors, to one where workers feel able to discuss their health issues and concerns, and to work directly with their employers to improve their working lives. The workplace is also an ideal site to educate and support workers specifically in relation to asthma and other health problems. This approach will benefit both the affected workers and their colleagues. In addition, the employer will have workers who are happy, healthier and here!

More information can be found at: British Thoracic Society Occupational Asthma Guidance


Prof. David Fishwick MBChB FRCP (UK) FFOM (hon) MD, is consultant respiratory physician and chief medical officer at the Health and Safety Laboratory (HSL)

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