Can we talk? Patients may avoid topic of work-related asthma for fear of losing jobs

According to a new study published in the Annals of Allergy, Asthma and Immunology, the scientific publication of the American College of Allergy, Asthma and Immunology (ACAAI), only 15 percent of employed adults with asthma discussed with their doctor how work might affect their condition. However, of the employed adults with asthma, 46 percent had asthma that was possibly work-related.

"Work-related asthma is under-diagnosed and under-recognized," said Jacek Mazurek, MD, MS, PhD, Public Health Surveillance Team Leader at the National Institute for Occupational Safety and Health, and lead author of the study. "A thorough occupational history is critical to first establishing a diagnosis of work-related asthma, and then putting measures in place to prevent further exposure, or to treat it."

Unfortunately, many people may believe that nothing can be done, or may worry about losing their jobs, so are reluctant to address the topic with their doctor."

The data for the survey was gathered by the Asthma Call-Back Survey -- telephone interviews conducted between 2006 and 2010 with more than 50,000 employed adults with asthma in 40 states and the District of Columbia.

"Hundreds of different workplace airborne exposures have been identified to cause or aggravate asthma," said allergist Mark S. Dykewicz, MD, Chair of the ACAAI Occupational Health Committee. "Problem exposures may include chemicals, dusts, fumes, insects and animals that are encountered not only in factories, but also farms, offices, medical and research settings and offices. If someone already has asthma, it can be worsened by airborne substances at work."

Questions which help identify work-related asthma include:

• Are there airborne exposures at your workplace that cause you to cough, wheeze or have shortness of breath?
• Do your symptoms improve when away from your job (on weekends or on vacation)?

Once workplace asthma develops, continuing exposure to some workplace agents can lead to permanent lung problems, and the risk for this can increase the longer the exposure continues. Medication alone may not prevent permanent damage. Therefore, early testing, and if needed, reduction or removal from a workplace exposure causing asthma is important. If you are having asthma symptoms that you believe are related to your work environment, you should discuss them with your allergist.

A board certified allergist, who is an asthma specialist, has knowledge about workplace asthma, can perform allergy testing, diagnose triggers and provide a personalized asthma management plan to help you manage your disease. According to the ACAAI handbook, "Asthma Management and the Allergist: Better Outcomes at Lower Cost," hospitalizations were significantly reduced when patients with moderate-to-severe asthma were seen by an allergist. Patients referred to allergists experienced a large drop in emergency visits and saw a significant reduction in missed days from work or school. Finally, patients who saw an allergist for their asthma had improved emotional and physical well-being and quality of life, and more satisfaction with the physician and with the quality of general medical care.