ERS satellite, March 2026
ASTHMA
Asthma in the workplace
Speaker
Johanna Feary, Senior Clinical Research Fellow, Imperial college, United Kingdom
Triggered by work? Environmental factors can cause or worsen asthma
Work-related asthma includes both occupational asthma and pre-existing asthma that gets worse at work due to factors in the workplace. According to speaker Johanna Feary, about 10% of adult asthma is attributable to work.
Erika Petersson
Medical digital content manager, Chiesi Nordic
Causes of work-related asthma
Work-related asthma includes work-aggravated asthma (asthma control deteriorate due to factors in the workplace) and occupational asthma, caused by factors in the workplace. The occupational asthma can be subdivided into three different categories:1
Irritant occupational asthma
- can be triggered by a single, but high exposure to an irritant, causing a rapid response. Includes RADS, reactive airways dysfunction syndrome. Non-sensitising fumes can also worsen existing asthma.
IgE-mediated, or
due to specific occupational agents with unknown pathomechanisms
- triggered by specific agents, proteins and chemicals via a sensitising mechanism with a latent period of 6-24 months.
Here, proteins refer to agents with high molecular mass, such as flours, eggs, seafood, mammal proteins (from mouse urinary proteins to large mammals), enzymes used in detergent industry and latex. They cause nasal symptoms and specific IgE response. Atopy increases the susceptibility for being sensitised. This makes working with animals or food (food processing or baking) high risk environments for occupational asthma. Chemicals with low molecular mass can also be sensitising agents, like diisocyanate and acrylates but also fine wood dust. At risk are professionals working with chemicals (manufacturing, processing, cleaning), wood, spray paint.1
How to identify work-related asthma
Patients of working age, presenting with new symptoms or reappearance of childhood asthma or worsening of asthma – ask what sort of work they do (if employed) and if symptoms are better or worse or the same on work days vs days off. If feasible, PEF monitoring every 3rd hour for 3-4 weeks can be carried out to reveal differences between days at work and at home. Allergenic pathogenesis should be confirmed with immunological tests. The earlier work-related asthma is recognized, the better the outcome. 1
Is leaving the job necessary?
Being in work is important as it provides individuals with income, social interaction, purpose and identity. A diagnosis of occupational asthma can have negative implications on employment outcomes. 2 Dr Feary shared a patient case where, by identifying the exact agent causing the occupational asthma, measures at the workplace could be taken to minimize the exposure. The patient could keep his job and symptoms were improved while exposure was reduced for all colleagues. Quitting the job should be the last resort, it is better to identify the exact agent and mitigate the risk of exposure.
Erika Petersson
Medical Digital Content Manager, Chiesi
References
- Baur, X et al. “Guidelines for the management of work-related asthma.” The European respiratory journal vol. 39,3 (2012): 529-45. doi:10.1183/09031936.00096111
- Barber, Christopher Michael et al. “British Thoracic Society Clinical Statement on occupational asthma.” Thorax vol. 77,5 (2022): 433-442. doi:10.1136/thoraxjnl-2021-218597
ID 20191-05.03.2026