ERS satellite, March 2026
ASTMA
Asthma in the workplace
Speaker
Johanna Feary, Senior Clinical Research Fellow, Imperial college, United Kingdom
Triggered by work? Environmental factors can cause or worsen asthma1
Work-related asthma includes both occupational asthma and pre-existing asthma that gets worse at work due to factors in the workplace.1 For around 20-25% of working individuals with asthma, asthma control may be adversely affected by factors in the workplace.2
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.2 Includes RADS, reactive airways dysfunction syndrome, now called acute Irritant Induced asthma (IIA).3 Non-sensitising fumes can also worsen existing asthma.1
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 ranging between a few weeks to many years.2
Here, proteins are typically agents with high molecular mass, such as flours, eggs, seafood, animal proteins (from mouse urinary proteins to large mammals), enzymes used in detergent industry and latex.2 They cause nasal symptoms and specific IgE response.2 Working with animals or food (food processing or baking) are high risk environments for occupational asthma.2 Atopy increases the susceptibility for being sensitised.2 Chemicals with low molecular mass can also be sensitising agents, like diisocyanate and acrylates but also fine wood dust.2 At risk are professionals working with chemicals (manufacturing, processing, cleaning), wood, spray paint.2
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.2 If feasible, PEF monitoring at least 4 times daily for 3-4 weeks can be carried out to reveal differences between days at work and at home.1,2 Allergenic pathogenesis should be confirmed with immunological tests.2 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.2 A diagnosis of occupational asthma can have negative implications on employment outcomes.2
Eliminating exposure to asthma-inducing agents is the strongest preventive approach to reducing the disease burden and onset of work-related asthma.1
References
- Baur X, Sigsgaard T, Aasen TB, et al. Guidelines for the management of work-related asthma. Eur Respir J. 2012 Mar;39(3):529–45. Erratum in: Eur Respir J. 2012 Jun;39(6):1553.
- Barber CM, Cullinan P, Feary J, et al. British Thoracic Society Clinical Statement on occupational asthma. Thorax. 2022 May;77(5):433–42.
- Barber CM, Cullinan P, Feary J, et al. British Thoracic Society Clinical Statement on occupational asthma. Thorax. 2022 May;77(5):433–442. Supplementary material available from: https://thorax.bmj.com/content/77/5/433
ID 20391-24.03.2026