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Occupational Asthma: A Silent Threat in the Workplace

Asthma is generally perceived as an individual condition, independent of the professional context. However, approximately 15% of adult asthma cases are closely linked to the workplace. It is essential to understand the dynamics, risks, and preventive measures associated with occupational asthma.

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Asthma is a chronic disease of the respiratory tract characterized by inflammation and narrowing of the bronchi. This condition leads to a decrease in air flow, which can make breathing difficult.

Occupational asthma presents in two distinct forms that deserve our attention:

  • Immunological Asthma: This is the most common form, marked by a latency period that extends from the time of the first exposure to the allergen until the onset of symptoms. This period allows the immune system to become sensitive to the causative agent.
  • Non-Immunological Asthma (Brooks Syndrome or Reactive Airways Dysfunction Syndrome (RADS)): It occurs following accidental massive exposure to an irritant substance, without requiring a latency period.

Professions in the red zone

It is particularly troubling that six industries are responsible for nearly half of occupational asthma cases:

  • Bakers and Pastry Chefs: Exposed to allergens such as flours and enzymes.
  • Healthcare Professions: Sensitive to latex, formaldehyde, and disinfectants.
  • Hairdressers: Exposed to hair care chemicals and latex.
  • Painters in the Automotive Industry: In contact with isocyanates.
  • Woodworkers: Exposed to wood dust, glues, and varnishes.
  • Cleaning Professions: Exposed to cleaning chemicals and latex.

Diagnostic and prevention

Accurate diagnosis is crucial for the treatment and management of occupational asthma. Diagnostic indicators include:

  • History of allergies or chemical exposures.
  • A pattern of symptoms related to the work cycle.
  • Clinical tests including respiratory function tests (RFT), skin tests, and specific IgE assays.

Management and Prevention

Removal of the causative agent is ideally the first step in treatment. However, this is not always feasible, especially in small and medium-sized enterprises where job reclassification is often necessary. In some cases, professional reorientation is inevitable.

Recognition of asthma as an occupational disease paves the way for compensation. Various social protection schemes exist, including table No. 66 for the general scheme and tables No. 36 and No. 45 for the agricultural sector, to name a few.

In conclusion:

Occupational asthma is a serious medical condition that requires special attention, both for its diagnosis and management. Healthcare professionals must identify these cases and offer suitable treatment solutions. Workers, especially those in at-risk professions, must be aware of the dangers to take the necessary preventive measures.

Philippe Casanova

Specialist in occupational medicine and forensic medicine.