Offices Harbour Unseen Asthma Triggers, Shows UK Study

Liam Davenport

September 07, 2021

Offices, air conditioning systems and the surrounding environment harbour a host of potential triggers for occupational asthma that, if left unaltered, can drive workers to leave their jobs, say UK researchers.

Dr Christopher Huntley, from University Hospitals Birmingham NHS Foundation Trust, and colleagues looked at more than 2700 occupational lung disease patients, identifying 47 with occupational asthma.

They found that printer toner, floor tile adhesive, mouldy air conditioning units, cleaning products, air fresheners, nearby workshops, and paint and vehicle fumes were all identifiable causes of asthma.

The research, presented at the European Respiratory Society (ERS) International Congress 2021 on September 6, also showed that when employers did not make necessary changes, workers were 100 times more likely to leave their jobs.

Home Working Benefits

"If a worker develops occupational asthma, workplace adjustments can and should be made to improve asthma symptoms and help retain staff," Dr Huntley said in a news release.

He added they have seen fewer referrals for occupational asthma since restrictions were introduced in response to the COVID-19 pandemic, and those with the disease have improved while working from home.

"Working from home has been useful for patients in both establishing their diagnosis and as a form of non-pharmacological treatment."

Dr Huntley said: "Allowing workers with occupational asthma to continue working from home may help keep office workers in their jobs as they require fewer sick days."

The study "demonstrates the need for more research into office-specific occupational asthma to enhance our understanding and identify any further causes", Dr Erika Kennington, head of research and innovation at Asthma UK and the British Lung Foundation, told Medscape News UK.

"Asthma is not taken seriously enough and on average three people sadly die from an asthma attack in the UK every day."

She urged "anyone with symptoms of work-related asthma" to contact their GP, adding that "once a diagnosis is found, then workplace adjustments should be immediately put in place to remove the trigger for their asthma symptoms".

Occupational Triggers

"We tend to think of office environments as relatively safe, compared with other occupational settings where exposure to pollutants may occur," commented Arzu Yorgancıoğlu, chair of the European Respiratory Society Advocacy Council and professor in pulmonology at Celal Bayar University, Turkey, in a news release.

Consequently, "it is likely that there are more patients out there with undiagnosed office work-related asthma".

Prof Yorgancıoğlu, who was not involved in the study, continued: "For office workers with asthma who experience an unexplained deterioration in their symptoms, this study highlights the importance of identifying and removing any potential occupational triggers.

"Where we see clusters of work-related asthma in offices it is vital to investigate the underlying cause," she said, as the causes may be "surprising".

Study Details

To determine the prevalence and causes of office-related occupational asthma, the researchers examined records from the Birmingham Occupational Lung Disease Service clinical database.

They identified 2761 occupational lung diseases recorded between 2000 and February 2021, among whom there were 54 cases of office-related occupational lung disease, with 47 diagnosed as occupational asthma.

Thirty-three (70.2%) of the occupational asthma cases were women, and the average age was 47.9 years. Eleven (23%) had pre-existing asthma and 35 (83%) had a positive score on OASYS analysis of serial peak flow monitoring.

Independent data review indicated that the cause of occupational asthma could be attributed to the internal office environment in 25 cases, the office ventilation system in seven cases and the external environment adjacent to the office in 11 cases. For four individuals, the cause was unknown.

Causes of occupational asthma within an internal office environment included printer/photocopier toner in seven cases, while acrylate floor adhesive accounted for four causes, cleaning agents for another four cases, air freshener/perfumes for two cases, and office dust for a further two cases.

Mould in the air conditioning was the cause in five cases, incorrect installation of the ventilation shaft accounted for two cases, while local workshops, diesel exhaust fumes, paint, and demolition dust accounted for seven cases.

If no workplace adjustments were made, employees were substantially more likely to leave their place of work than if those adjustments were made, at an odds ratio of 101.3 (95% CI 10.4–990.3).

In one example, the researchers showed that an IT worker with occupational asthma due to exposure to cleaning agents saw their symptoms abate when they were away from the office on training, and resolve when they worked from home.

"Although we only looked at the patients who were referred to our service and this is a relatively small study, it is still one of the largest studies reporting occupational asthma in office workers," Dr Huntley said.

"We discovered some key causes to be aware of in an office environment, but there will certainly be others."

No funding declared.

No relevant financial relationships declared.

European Respiratory Society International Congress 2021: Abstract PA1904. Presented 6 September


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