Occupational Diseases that occurred in working environment that affects employees.

1. INTRODUCTION TO OCCUPATIONAL DISEASE
An Occupational disease is disease or disorder that is caused by work or working
conditions. This means that the disease must have developed due to exposure at the
workplace. And that the correlation between the exposures and the disease is well
known in medical research. Or put on another way, it must not be likely, beyond
reasonable doubt that the disease is caused by factor other than work. Exposure in
the workplace that may cause some of this disease repetitive work movements, work
with arms lifted above shoulder height, heavy lifting work, work in a very noisy
environment and work with hazardous substances. When there is adequate medical
documentation that a disease is caused by a certain exposures, the disease is
included in the list occupation disease.
In order to get compensation and other benefits as a consequence of a disease, the
disease must be recognised as an industrial injury. A disease can be recognised in
two different way. If the disease and the exposure causing the disease are on the list
on occupational disease we recognised the disease as occupational disease. If the
disease are not on occupational diseases, it is still possible to recognised it as a
occupational disease if the occupational disease committee, in their
recommendation, state that is likely, beyond reasonable doubt, that the disease was
caused by special factors in the workplace.
there is a presumption that specific disease are caused by the worker being in the
work environment and the burden is on the employer or insurer to show that the
disease came about from another cause .Diseases compensated by national
workers compensation authorities are often termed occupational diseases.

2. OCCUPATIONAL DISEASE ASTHMA
Work-related asthma is one of the most frequently reported occupational lung
diseases. If you have asthma, exposures in the workplace can be a cause of asthma
symptoms. And, for some people being exposed to certain chemicals, irritants or
allergens can cause asthma to develop for the very first time.
Whether you work indoors or outdoors, the work environment can expose you to
irritants and allergens that may be different from what you encounter at home.
Industrial or wood dusts, chemical fumes, solvents, pests, molds, secondhand
smoke, vehicle exhaust, ozone and particulate matter air pollution are just a few
common exposures at work
Asthma is an occupational condition that can be defined as ’a disease characterized
by variable airflow limitation and/or airway hyper-responsiveness due to causes and
conditions attributable to a particular occupational environment and not stimuli
encountered outside the workplace’. Occupational asthma has a vast number of
occupations at risk. Bad indoor air quality may predispose for disease in the lungs as
well as in other parts of the body.
Asthma is a chronic, or life-long, disease that can be serious even life threatening.
There is no cure for asthma. The good news is that it can be managed so people can
live a normal, healthy life. Asthma is a lung disease that makes it harder to move air
in and out of your lungs. When you breathe, air passes through your nose and down
your throat into your lungs. Inside your lungs are branching tubes called airways.

3. With asthma, the airways are often swollen and red or inflamed. This makes them
extra sensitive to things that you are exposed to in the environment every day or
asthma “triggers”. A trigger could be a cold, the weather, or things in the
environment, such as dust, chemicals, smoke and pet dander. When someone with
asthma breathes in a trigger, the insides of the airways make extra mucus and swell
even more. This narrows the space for the air to move in and out of the lungs. The
muscles that wrap around your airways can also tighten, making breathing even
harder. When that happens its called as an asthma flare up, asthma episode or
asthma attack.
Occupational asthma is asthma that's caused or worsened by breathing in chemical
fumes, gases, dust or other substances on the job. Like other types of asthma,
occupational asthma can cause chest tightness, wheezing and shortness of breath.
When treated early, occupational asthma may be reversible. Long-term exposure to
allergy-causing substances can cause worsening symptoms and lifelong asthma.
Treatment for occupational asthma is similar to treatment for other types of asthma,
and it generally includes taking medications to reduce symptoms. But the only sure
way to eliminate your symptoms and prevent lung damage due to occupational
asthma is to avoid whatever's triggering it. Occupational asthma symptoms are
similar to those caused by other types of asthma. Signs and symptoms may include
Wheezing sometimes just at night, Coughing, Shortness of breath and Chest
tightness. Other possible accompanying signs and symptoms may include runny
nose, Nasal congestion, Eye irritation and tearing.

4. Occupational asthma symptoms depend on the substance you're exposed to, how
long and how often you're exposed, and other factors. Your symptoms may Get
worse as the workweek progresses, go away during weekends and vacations, and
recur when you return to work. Occur both at work and away from work. Start as
soon as you're exposed to an asthma-inducing substance at work or only after a
period of regular exposure to the substance. Continue after exposure is stopped.
The longer you're exposed to the asthma-causing substance, the more likely you'll
have long-lasting or permanent asthma symptoms.
More than 300 workplace substances have been identified as possible causes of
occupational asthma. These substances include animals substances such as protein
found in dander , hair, scales ,fur , saliva and body wastes. Chemical such as
anhydrides, disocyanates and acids used to make paints, varnishes, adhesives,
laminates and soldering resin. Other examples include chemicals used to make
insulation, packaging materials, and foam mattresses and upholstery.
Occupational asthma refers to cases of asthma caused by specific agents in the
workplace. Occupational asthma can be further divided into two groups. Sensitizer-
induced asthma - caused by sensitization (reaction) to a substance Irritant-induced
asthma also called reactive airways dysfunction syndrome, or RADS which is caused
by one specific, high-level exposure
Work exacerbated asthma is those who have a worsening of their asthma symptoms
while at work .Not all workers will react with an asthmatic response when exposed to
substances. Asthmatic attacks can be controlled either by ending exposure to the
substance, or by medical treatment to manage the asthma symptoms.

5. HOW DOES OCCUPATIONAL ASTHMA DEVELOP
Sometimes, the body can develop a sensitization (an allergic-type) reaction when it
is exposed continuously to a substance. The process is usually not immediate it
involves over a period of time and involves the body's immune system. A complex
defense system protects the body from harm caused by foreign substances or
microbes. Among the most important elements of the defense mechanism are
special proteins called "antibodies." Antibodies are produced when the human body
contacts an alien substance or microbe. The role of the antibodies is to react with
substances or microbes and destroy them. Antibodies are often very selective, acting
only on one particular substance or type of microbe.
But antibodies can also respond in a wrong way and cause disorders such as
asthma. After a period of exposure to a substance, either natural or synthetic, a
worker may start producing too many of the antibodies called "immunoglobulin E".
These antibodies attach to specific cells in the lung in a process known as
"sensitization." The sensitization may not show any symptoms of disease, or it may
be associated with skin rashes (urticaria), hay fever-like symptoms, or a combination
of these symptoms.

6. WHAT FACTORS THAT INCREASE ASTHMA AT THE
WORKPLACE
Some workplace conditions seem to increase the likelihood that workers will develop
asthma, but their importance is not fully known. Factors such as the properties of the
chemicals, and the amount and duration of exposure are important. However,
because only a fraction of exposed workers are affected, factors unique to individual
workers can also be important. Such factors include the ability of some people to
produce abnormal amounts of antibodies. The contribution of cigarette smoking to
asthma is not known. However, smokers are more likely than non smokers to
develop respiratory problems in general.
Although there are medical treatments that may control the symptoms of asthma, it is
important to stop exposure wherever possible. If the exposure to the substance is
not stopped, treatment will be needed continuously and the breathing problems may
become permanent. People may continue to suffer from work-related asthma even
after removal from exposure. The best way to prevent work-related asthma is to
replace substances with less harmful ones. Where this is not possible, exposure
should be minimized through engineering controls such as ventilation and
enclosures of processes

7. HOW TO REDUCE THE NUMBER OF INJURY ASTHMA AT
THE WORKPLACE
Preventing further exposure might involve administrative controls such as a change
of job or tasks .Education of workers is also very important. Proper handling
procedures, avoidance of spills and good housekeeping reduce the occurrence of
asthma.
Education of workers is also very important. Proper handling procedures, avoidance
of spills and good housekeeping reduce the occurrence of asthma .Masks or
respirators can also help to control workplace exposure. Personal protective
equipment is considered the last option for control measures. In order to be effective
these protective devices must be carefully selected, properly fitted and well
maintained as part of a full personal protective personal equipment (PPE)
Occupational asthma can be controlled..Prevent the disease by reducing or
eliminating environmental allergens and irritants. Detect the disease early, even
before symptoms appear, by using surveillance measures. Avoid worsening
symptoms by preventing exposure or using something less harmful.

8. LIST THE SUBSTANCE THAT CAN CAUSE ASTHMA AT THE
WORKPLACE
Alpha amylases
Enzymes that change starch into sugar. Used in flour milling and bread
baking. Also used in detergents, animal feed, textile processing and brewing
C37/ C21, C22
Azodicarbonamide
Used in the expansion of polymers in the rubber and plastics industries C1
Bromelains
Enzymes within the fruit, stem and leaves of the pineapple. Used
pharmaceutically as an aid to digestion and as an anti-inflammatory agent
C38
Carmine
An insect-derived dyestuff. Used for cosmetic and pharmaceutical dyeing and
as a food and drink colouring C2
Castor bean dust
Castor oil is used in paint, varnish, hydraulic fluids, printing inks, nylon,
plastics and cosmetics and hair oils C3
Cephalosporins
Antibiotics similar to penicillin C39

9. Chloramine-T
A disinfectant with antiviral, bactericidal and fungicidal properties. Highly
reactive with proteins C4
Cockroach material
Dust from the bodies, eggs, saliva, faeces and cast skins of cockroaches C40
Coffee bean dust
Dust from the processing of coffee beans C30
Cow epithelium/urine
Dust from cow hair and dander C8
Crustacean proteins
From the processing of prawns, crabs, shrimps and lobsters C9

10. WHAT CAUSES OCCUPATIONAL ASTHMA
A wide range of animal- and plant-derived proteins, insect and plant dusts,
chemicals, pharmaceutical agents and bacterial enzymes are believed to cause
occupational asthma. They are deposited in the lung in various ways, depending on
their size and shape.
The symptoms of occupational asthma can occur in several ways. The main
distinction is whether the symptoms are an allergic reaction or an irritant reaction:
For an allergic reaction to occur, a worker must first be sensitized to a substance,
usually a protein, called an allergen. That is, the body's immune system on first
exposure to this substance misreads the allergen as a foreign substance and makes
antibodies to get rid of it. Once this sensitization takes place, it constitutes a
permanent occupational injury. An allergic reaction can occur when the patient is
again exposed to the substance. Constant exposure can result in severe, disabling
asthma.
Scientists know little about the length of exposure or the dose needed to produce an
allergic response. In most cases, there is a latent period of days or years after first
exposure to the occupational allergen before symptoms occur. But once the worker
is exposed, very low levels of the substance can provoke an asthmatic reaction
.Irritant reactions to substances are more common than allergic reactions and are
the short-term worsening of a condition already present.
Proving the difference between a permanent allergic injury and a temporary irritant
reaction is not perfect. It relies on experience and a detailed history of the condition
that includes review of symptoms before starting the job, a physical exam and
diagnostic testing .Scientists also have identified a syndrome—Reactive Airways
Dysfunction Syndrome (RADS)—which falls somewhere between an acute irritant
reaction and allergen- induced asthma. Typically an intense onetime irritant
exposure is followed by asthma-like symptoms of coughing, wheezing and shortness
of breath. This resolves over days or weeks—and sometimes months.

11. WHAT ARE THE SYMPTOMS OF OCCUPATIONAL ASTHMA
Physical symptoms include coughing, wheezing, breathing problems and chest
tightness. The skin, eyes and nose may become inflamed. Three basic patterns of
asthmatic response can be seen:
A prompt response of trouble breathing and wheezing within minutes of exposure
to the allergen. The condition is worse in 10 to 30 minutes and clears up in 1 to 2
hours. Symptoms often go away soon after the worker leaves the workplace and do
not recur on weekends.
A delayed or late onset reaction, which often begins 1 to 6 hours after exposure and
peaks in 3 to 8 hours. Sometimes it lasts 2 to 36 hours and can recur nightly after a
single exposure. It may take days or weeks to resolve.
A dual response, both prompt and late onset. Symptoms begin within minutes of
exposure and return to normal in 1 to 2 hours. Symptoms flare up again in the
evening or after bedtime and continue in some patients for up to 12 hours.
Spill of an agent can cause high-level exposure that triggers a reaction quickly If
there is a period of time between first exposure to a workplace agent and onset of
symptoms, allergies should be suspected. To confirm your asthma, your doctor will
give you breathing tests before and after giving you an airways-opening medication.
In a challenge test, the doctor may try to reproduce symptoms. You will be asked to
inhale histamine or methacholine to provoke a response.

12. Picture 1 : Dust can cause asthma. Example at the workplace contractor they
exposure to dust
Picture 2 : example for employee that exposure to dust , chemical they got asthma

13. Picture 3 : example for occupational asthma
Picture 4 : example for occupational asthma

14. REFERENCE
1) www.ccohs.ca/oshanwers/disease/asthma/htm.
canadian centre for occupationalhealth and safety
2 ) www.hse.gov.uk/asthma
health and safety executive
3)www.lung.org/lungsdisease/asthma/creative-asthma
American lungs association
4) www.aafa.org/display.cfm?id
asthma and allergy foundation of america