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Occupational asthma is defined as:
Asthma is defined as a respiratory disease caused by narrowing of the air passages. It is synonymous with difficulty in breathing, tightness of chest, nasal irritation, coughing and wheezing. The first person to use it in reference to a medical condition was Hippocrates, and he believed that tailors, anglers and metalworkers were more likely to be affected by the disease. Although much research has been done since, the inflammatory component of asthma was recognized only in the 1960s.
Today, asthma affects as much as 15% of the Canadian population[2] (and this is true of other developed countries too) and has increased four fold in the last 20 years. Various reasons can be identified for this increase – Of course better diagnosis and facilities along with a greater awareness regarding the disease have played a major role. But, one cannot deny the part of increased environmental pollution. Researchers have been working on the relation between the environment and human health since long and the air we breathe is the primary cause for lung diseases like asthma, rhinitis, COPDs, etc. that affect us today.
Approximately 10 to 15% of the adults affected by the disease report an aggravation of their symptoms while at work and an improvement when away, which implies that they may be suffering from Occupational Asthma. Thus, when an individual’s Asthma is caused, not aggravated, by workplace materials, it is defined as Occupational Asthma. In the USA, OA is considered the most common occupational lung disease[3]. At present, over 400 workplace substances have been identified as having asthmagenic or allergenic properties[4]. Their existence and magnitude vary from region to region and the type of industry and can be as varied as wood dust (cedar, ebony, etc.), persulfates (Hairsprays), zinc or even seafood like prawns. For example, in France the industries most affected in order of importance are Bakeries and cake-shops, automobile industry and hairdressers[5], whereas in Canada the principal cause is wood dust, followed by isocyanates.
In 1700, Bernardino Ramazzini, Doctor of Philosophy and Medicine from Parma, Italy published the book “De Morbis Artificum Diatriba” (A Treatise on the Diseases of Workers). Although researchers like Olaus Magus had done work on diseases due to occupational causes as early as 1555, this was the first comprehensive work on work-related diseases. This volume described in detail the diseases of workers in 52 different occupations[6]. Thus, it was the basis for the emergence of occupational medicine and even today, it is an important reference. Due to his important contribution to this field, Dr. Ramazzini is considered the father of occupational medicine.
Similarly, for his contribution to research on asthma in the workplace, Dr Jack Pepys is considered as the Father of Occupational Asthma[7]. His work on the role of Aspergillus species in pulmonary diseases as also on the cause of farmer’s lung have heavily influenced the emergence of OA as an occupational disease. And, thanks to his work on Specific Inhalation Challenge, the compensatible aspect of the disease was recognized.
Less than five years of exposure to an occupational agent can be enough for the appearance of the first OA symptoms. This depends on whether the reason for the OA to occur was exposure to the causative agent over a period of time (with a latency period) or a single exposure to an irritant but at a very high concentration (without latency period). Both eventually result in OA. Coughing, wheezing, nasal irritation, difficulty in breathing, tightness of chest are the most common symptoms and can be recognized more easily by asking oneself the following questions:
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