What is asthma?

Asthma is a chronic disease involving inflammation of the airways. Certain triggers cause the inflammation, which narrows the airways and limits the amount of air available to the lungs. For sufferers this results in difficulty breathing, causing a major impediment to everyday life and the risk of a life-threatening asthma attack.

Asthma is common, affecting over 300 million people worldwide. Here in Australia, asthma affects around 2.1 million people. One in nine adults suffers from asthma and it is our most widespread chronic health problem.

As Australia’s leading chronic disease, asthma has a significant impact on our workplace health and wellbeing, and economy. A snapshot of the effects on chronic disease in Australia reveals:

• Only 48 per cent of people with a chronic disease such as asthma were likely to be in full-time employment, compared with 61 per cent who did not have a chronic disease;
• Australians affected by chronic disease take almost double the amount of time off work than those workers who do not have a chronic disease;
• Asthma accounts for 23 per cent of the total loss of work days in Australia attributed to chronic disease;
• A greater proportion of people with asthma had days away from work or study in the last two weeks (16.6%) than people without asthma (10.7%); and
• In 2003, the equivalent of 63,100 years of healthy life was lost due to asthma.

People with asthma report a poorer quality of life, with less involvement in social and sporting activities. They also suffer from a higher incidence of anxiety and depression than people without asthma. The most recent statistics reveal that 385 Australians died from asthma in a year.

What are the symptoms of asthma?

• Wheezing;
• Shortness of breath;
• Coughing;
• Rapid breathing;
• Neck and chest tightness/ pain; and
• Panic and anxiety.

Symptoms usually manifest as a mild asthma attack, which most sufferers can relieve with inhaler medication. The airways will usually open back up minutes after this kind of treatment. Some people experience mild asthma attacks daily, while others go for longer periods of time without any. The key here is to treat symptoms as soon as they occur, so as to avoid symptoms developing into a more severe attack.

A severe asthma attack causes the airways to restrict to the point where very little air is inhaled, putting the sufferer at risk of losing consciousness or suffocating.

What are the causes?

Asthma is thought to develop due to a combination of both environmental and genetic factors. While the genetic causes of asthma are still largely unknown, understanding the environmental factors that exacerbate asthma helps significantly in controlling the symptoms.

“Triggers” are the environmental risk factors that precipitate the onset of asthma symptoms in people who suffer from the disease. Triggers include:

• Allergens;
• Animal dander or dust mites;
• Tobacco smoke;
• Exercise;
• Cold-air;
• Certain chemicals or substances;
• Low air quality or pollution; and
• Viral infections.

Minimising exposure to these triggers helps many asthma sufferers reduce the frequency and severity of their asthma symptoms. While asthma is not “curable” in many sufferers as such, successful treatment can come through management of the symptoms and avoidance of triggers.

Asthma in the workplace

Asthma also develops as an occupational disease. Up to 3000 cases of Occupational Asthma occur each year in Australia and it is the most common occupational lung disease in industrialised countries. Exposure to certain substances in the workplace can lead to workers with no history of asthma developing the chronic disease.

Workplace risk factors

Occupational asthma is a potential risk to many otherwise healthy workers, accounting for up to 15 per cent of all adult-onset asthma in Australia. Occupational asthma can develop in workers when they are exposed to certain “sensitising” substances, which increase the likelihood of the disease developing in people who can have not ever previously suffered from asthma.

If diagnosis is made early and the affected person avoids further exposure to occupational asthma sensitisers in the workplace, symptoms may resolve completely. If left untreated, occupational asthma may worsen and has even known to cause a low number of deaths.

Workers developing occupational asthma often first display symptoms of a persistent cold, such as:

• Recurring soreness or watering of eyes;
• Recurring clocked or running nose;
• Bouts of coughing;
• Chest tightness;
• Wheezing of breath, especially upon exhalation;
• Breathlessness;
• Any other persistent or history of chest problems; and
• Symptoms that appear to improve on weekends or during holidays (i.e. when worker is away from the workplace).

Occupational asthma often has no symptoms in its developing stages. This is why it’s critical to be aware of the risks factors, such as the presence of sensitiser substances in your workplace, and to minimise workers’ exposure to them. Some known sensitiser substances include:

• Isocyanates (or products labelled R42/43) used in the chemical, adhesive and automotive industries. Also used by carpenters, foundry workers, joiners, mechanics, metallurgists, printers, painters and tinsmiths.
• Wood dust in the paper and timber industries. Exposure to builders, carpenters, joiners and model builders
• Flour and grain dust from animal foodstuffs, and food and food processing industries. Exposure to animal breeders, bakers, butchers, cooks, dockers and farmers.
• Animals used in the pharmaceutical and food processing industries. Exposure to animal breeders, biologists, farmers, pet shop workers and veterinary surgeons.
• Latex used by textile industries, health care workers, workers involved in the manufacture of surgical gloves and toys.
• Formaldehyde used by the chemical, plastics, rubber, cosmetics and paper industries. Also used by carpenters, embalmers, foundry workers, hairdressers, health care workers, laboratory staff and tanners.
• Platinum salts used in the electronics industry and by chemists, dentists, jewellers, metallurgists, nurses, photographers and refinery workers.

This list is by no means exhaustive, but it demonstrates how many potential risk factors there are for occupational asthma. 

What can you do about it?

Modify existing risk factors:

• Minimise workers’ exposure to asthma causing substances;
• Try to substitute known sensitiser agents with safer ones;
• Provide adequate ventilation and respiratory equipment where you cannot minimise exposure;
• Provide flexibility for workers who have developed occupational asthma. Consult with their doctor and try to provide roles in other areas of your workplace;
• Educate your workers on the recognition and prevention of occupational asthma; and
• Ensure you deal with symptoms as soon as possible, so as to avoid developing chronic illness in your workplace.

As with all chronic disease, early intervention is the key. Be aware of the risks to the workers in your workplace -everybody has a right to breathe easy at work.

More information can be found at The National Asthma Council of Australia and The Asthma Foundation of Victoria.