Asthma is an inflammatory disorder of the airways which leads to them becoming inflamed, muscles in the airways tightening, and too much mucus being produced. As the airways narrow, the air has more difficulty getting in and out and this is what causes the person with asthma to have problems in breathing.

Asthma symptoms can include coughing, wheezing, shortness of breath and a tightening around the chest. For some sufferers the symptoms are so severe that they cannot work again.

This information sheet deals with asthma that is caused by work, and asthma that is made worse by work. It will give a brief outline of the law, and say what safety representatives should do to help ensure that they prevent occupational asthma in their workplace.

Workplace asthma

Occupational asthma is caused when workers breathe in substances at work that leads to them developing a sensitivity to it. The body sets off an immune reaction to the substance, and any further exposure can bring about an attack. In some cases the symptoms develop immediately after exposure, but for some people they will not appear until several hours later, often at night.

Once a person has been sensitised to dust or chemical, further exposure to that substance, even at very low levels, can lead to further attacks.

There are over 200 substances that are known to be capable of causing occupational asthma. The most common of these are a group of chemicals called isocyanates. These are found in many paints and foams. Other common causes of asthma are flour dust, latex (in particular latex gloves), wood dust, some glues and resins, solder fumes, laboratory animals, some reactive dyes, cobalt, enzymes (in detergents), and even certain insects such as mites.

Among the groups of workers most at risk of inhaling these substances are bakery workers, spray painters, cleaners, nursing and care staff, catering workers, lab technicians and woodworkers.

Work related asthma is where a person is exposed to a substance that can cause asthma where the y already have a pre-existing history of asthma (such as childhood asthma). This means that some substances that are found in the workplace can provoke attacks in people who have either already got occupational asthma or even a pre-existing asthma that they have had from childhood. Work related asthma can be caused through exposure to substances such as chlorine, ammonia and sulphur dioxide. It can also be triggered by tobacco smoke, general dust or cold air.

The extent of occupational asthma can be difficult to estimate as often it is difficult to know whether a person has developed asthma because of contact at work, or elsewhere. However the Health and Safety Executive estimates 1,500 to 3,000 new cases of occupational asthma arise every year, but this rises to 7,000 cases a year if you include asthma made worse by work. It is believed that occupational asthma may account for around 10% of all cases of adult asthma.

However it is important to emphasise that occupational asthma can be very easily prevented through preventing exposure to those chemicals and dusts that are know to trigger or cause asthma.

The law

The Control of Substances Hazardous to Health Regulations (COSHH) spell out what employers must do to reduce the risk of hazardous substances, including those that can cause asthma. There is also an Approved Code of Practice on controlling substances that can cause occupational asthma.

COSHH is a legal requirement and employers should follow the Approved Code of Practice on asthma if they want to make sure that they are fulfilling their obligations under the law.

COSHH sets out simple measures that employers should take to ensure they protect their workforce. These are to

· assess the risks

· decide what precautions are needed

· prevent or adequately control exposure (ideally through removing the substance and substituting another less hazardous instead, and if that is not possible then to reduce it to as low a level as possible and prevent any exposure through enclosing the process, ventilation or extractor fans.)

· As a last resort, if all other measures fail to reduce exposure to a safe level, then personal protective equipment such as face- masks should be used.

· ensure control measures are used and maintained

· monitor the exposure regularly

· carry out appropriate surveillance and

· ensure employees are properly informed of the relevant risks, trained and supervised.

Employers need to bear in mind that substances that can cause occupational asthma are often very different from other hazardous substances. This is because the amount of a substance that is needed to produce sensitivity and lead to asthma varies considerably between individuals. In addition only a minority of individuals at risk will actually develop asthma. Once a person develops hypersensitivity as a result of exposure to a substance that causes asthma it is irreversible, however people develop symptoms of asthma at much lower levels than those which will cause hypersensitivity and if people are removed from exposure to the substance as soon as they start to develop symptoms, they are likely to make a complete recovery.

It is for that reason that it is extremely important that employees are informed of both the symptoms and risks of asthma and asked to report any symptoms immediately.

Employers are also required to report cases of occupational asthma to the Health and Safety Executive. In addition any person who develops asthma may be covered by the Disability Discrimination Act. The employer would then be required to make suitable adaptations to ensure that they are kept working without being exposed to any substance that may trigger an attack. This will normally mean removing exposure to the substance that is causing the asthma attacks. Ideally that should be done by looking at substitutes or redesigning the job however in some circumstances unions will want to negotiate redeployment to a similar job where there is no possibility of exposure.

However safety representatives have to be aware that if a person has developed asthma then simply moving them to another job will not protect other workers who may also be exposed.

If an employee does develop asthma or have a pre-existing condition worsened, as a result of exposure in the workplace then the employer may be liable for compensation. Occupational asthma is also a recognised industrial disease for industrial injuries benefit purposes.

What safety representatives can do

The first thing is to recognise that asthma is a preventable disease, however prompt diagnosis and treatment are crucial. Workers should not be exposed to any substance that can cause or trigger occupational asthma and safety representatives should inspect their workplace for potential asthma risks.

Safety representatives can get information on the substances that can cause occupational asthma on the HSE website at http:\\www.hse.gov.uk\asthma. In addition the list of substances with exposure limits can also be found on the main HSE website.

Safety representatives should make sure that they ask for copies of the risk assessments that the employer has done to ensure that they are preventing exposure to asthma-causing substances, and make sure that their employer is notifying them of any cases of suspected occupational asthma within the workplace.

Where control measures are in place then safety representatives should ensure that they are being adhered to and maintained and also that they are being effective in preventing asthma.

Finally they should make sure that, where there is any potential asthma risk, that their employer has given all their workforce appropriate training and information on both the symptoms of asthma and how to avoid it. In addition a system of health surveillance should be in place wherever there is an asthma risk.

For more information on asthma generally, go to the website of Asthma UK at http:\\www.asthma.org.uk

Fact sheet (1,400 words) issued 2 Jul 2004

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