When Your Job Makes You Sick — Literally

When Your Job Makes You Sick — Literally

By KATHERINE HEINECox News ServiceWednesday, October 05, 2005
WACO, Texas — The Monday morning grogginess hadn't worn off by the time the doctor reached the hospital, so he veered toward the cafeteria for some coffee. The day's schedule ran through his mind as he inhaled the cup's roasted aroma and with it some baker's yeast that had wafted out from the kitchen.
He sipped the last of his coffee and sped toward the outpatient clinic for his first surgery of the day. The surgeon scrubbed his hands with antiseptic soap and ripped open a package of latex gloves, releasing the familiar powder into the atmosphere. His chest tightened and eyes watered as he hovered over the operating table, but he assumed it was nerves. It wasn't nerves — it was his asthmatic reaction to the baker's yeast.
Each day an estimated 11 million workers in the United States are exposed to at least one of the hundreds of agents associated with occupational asthma. The disease, characterized by breathing difficulties from repeated exposure to workplace allergens, is believed to contribute to 5 percent to 15 percent of all asthma cases, according to the Allergy and Asthma Foundation of America.
Many cases remain undiagnosed because the symptoms are varied and one's response to irritants is often delayed. A meat packer, for instance, might attribute his runny nose and skin rash to mowing the yard the day before instead of his sensitivity to the plastics he melted during the meat wrapping process.
Although manufacturing plants report more incidences of occupational-related asthma than office jobs, all workplaces host possible triggers for the wheezing, chest tightness, eye irritation and nasal congestion associated with the ailment. Epoxy resins threaten auto mechanics; fur and grain dust put farmers and animal shelter workers at risk; and latex and antiseptics may harm hospital employees.
The National Institute of Occupational Safety and Health reported that 140,000 workers in the United States are exposed to acid anhydride compounds, chemicals used to produce epoxy resins, adhesives and fire retardants. Of these workers, an estimated 20 percent have allergic asthma, the most common form of the disease.
According to the foundation, 30 percent of bakers exposed to flour dust develop asthma.
Pulmonary critical care specialist Dr. William Petersen of Scott & White Hospital in Temple said a debate rages within the medical community as to whether irritants found in the workplace cause asthma outright or simply expose a pre-existing condition.
"Asthma in itself is such a common condition, and for instance, if a patient comes in saying that his work environment gave him asthma, but I find out he smoked for 15 years, which is it if not both?" Petersen said. "It is hard, even with lung and skin tests, which can be negative, to pinpoint what exactly out of all the agents in a workplace precipitated the asthma."
Pinning down the irritating workplace agent in a case of occupational asthma brings out doctors' inner detectives as they weed through a patient's daily exposure to hundreds of allergens associated with the ailment. Petersen said the process is further complicated by an often delayed asthmatic response and occupational asthma's tendency to produce nontraditional symptoms.
The Allergy and Asthma Foundation said responses can range from breathing difficulties that occur within minutes of exposure and last up to two hours to a late onset reaction, which often begins one to six hours after exposure, may last up to 36 hours and can recur nightly after a single exposure.
The late onset, Petersen said, makes it difficult for patients and doctors to classify the offending allergen.
Asthma is the leading cause of absenteeism from school and accounts for 14.5 million missed days of work for adults each year. Linda Morris, an instructor with the Texas State Technical College department of environmental health and safety technology, said employers and occupational safety officers are taking a hard look at the work environment's contribution to the epidemic, which has nearly doubled in cases in the past 15 years.
The world of work is undergoing a culture change, Morris said. Safety and complying with the Occupational Safety and Health Administration's exposure limits and standards for protective gear are becoming priorities for businesses because the costs associated with frequent medical visits and potential lawsuits are greater than the costs to install proper ventilation and provide dust masks. Asthma accounts for $14 billion in medical expenses and indirect costs, according to the foundation.
"Federal regulations and permissible exposure limits are set to protect workers, and more and more employers are realizing that if you have a happy, healthy population of workers, you have a more efficient workplace with less turnover," she said. "What we are finding is that these set levels protect the mainstream workforce, but there are susceptible populations with pre-existing conditions that require lower levels."
Morris said many safety professionals are urging OSHA to implement more restrictive exposure limits to protect more susceptible populations. The TSTC instructor said OSHA, the government's arm charged with enforcing workplace inhalant and emission standards, doesn't go around testing various plants for compliance because it has its hands full responding to workers' complaints. But Morris applauds the entity's renewed dedication to bringing the nation's smaller businesses up to speed.
Morris said workers should make sure their employers are taking steps to ensure their safety. Businesses should be installing engineering controls, such as ventilation mechanisms or other air quality systems, to reduce contaminants.
If agents in the air continue to affect workers, employers should make every effort to rotate workers or place them in another department. Petersen said he has written letters to employers explaining that lung and skin tests revealed a patient's asthmatic reaction to inhalants at work. A compliant workforce should then provide personal protective equipment, from dust masks to full face respirators. In the worst cases, workers have to change jobs.
"Everyone has to breathe, so inhaling irritating particles and chemicals at work is one of the main hazards in the workplace," Morris said. "Too many people think asthma only applies to the pollen and pet dander they hear about in commercials. But there are hundreds of irritations in the air. The list of 200 that OSHA has on the Internet is only those most commonly associated with asthma or most carcinogenic."
You might have occupational asthma if ... - you experience an onset of symptoms within months of starting a job.- you find yourself reacting to the use of a new industrial agent or process.- your symptoms improve after leaving work or clear up on weekends or holidays.- your symptoms worsen during certain points of production or during intense exposures to a specific particle.- you notice other workers complaining of itchy eyes, wheezing, nasal congestion or taking frequent sick days for head or chest colds.
Source: Allergy and Asthma Foundation of America
Katherine Heine writes for the Waco Tribune-Herald.

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