National Asthma Awareness Month: Help Your Employees Breathe Easy

Welding fumes and metalworking dusts put employees at risk for asthma and other respiratory problems. Are you doing everything you can to protect your workers' lungs? Here's what manufacturers should know about indoor air quality and respiratory health.

The Link Between Air Quality and Asthma in Manufacturing

Asthma can be both a risk factor for breathing problems in manufacturing and a direct result of exposure to weld fumes and other toxic particulates.

Manufacturing workers are at high risk for occupational asthma if they are exposed to high levels of fumes or dust. All kinds of manufacturing dusts irritate the lungs, but some are more likely to result in asthma than others. Some of the dust types with the highest exposure risks in manufacturing include:

• Welding fumes, especially fumes from stainless steel welding containing hexavalent chromium (hex chrome)
• Metalworking dusts, especially those containing cobalt, chromium, or nickel
• Soldering resin
• Wood and paper dust
• Food processing dusts containing cereal grains or animal proteins
• Pharmaceutical dusts
• Pigments and dyes
• Plastics, rubber, and latex
• Adhesives and insulation

These substances can produce an immune reaction in the body that triggers asthma in susceptible individuals. Over time, occupational exposure can lead to the development of asthma in workers who have never had it before.

At the same time, workers who already have asthma are at special risk when working in environments with poor indoor air quality. People with asthma are often operating with compromised lung function that may not be noticeable under normal circumstances but can quickly become life threatening if they are explosed to substances that further limit their lung capacity.

Recognizing Asthma in the Workplace

It is important to make sure that all workers recognize the signs of asthma and know when to get help. An asthma attack can come on quickly and rapidly become a life-threatening emergency. Workers who have never experienced an asthma attack before, or who believe that their asthma is mild and under control, may be surprised at how quickly an occupational exposure can trigger a serious attack.

Sometimes, people suffering from an asthma attack may think that they are simply fighting congestion from a cold or other respiratory infection. But asthma symptoms can be much more serious. Asthma causes tightening of the muscles around the airways, called a "bronchospasm." The lining of the airways can also swell and may produce significant amounts of mucus, further limiting the ability to breathe. This combination of symptoms reduces the ability to take air into the lungs, and may cut off breathing entirely.

Occupational asthma symptoms are largely the same as those caused by other types of asthma. Signs to watch out for include:

• Wheezing (listen for characteristic whistling sounds when the person breathes in and out)
• Uncontrolled coughing
• A feeling of tightness or pressure in the chest
• Rapid breathing
• Tightening of the neck or chest muscles (retractions)
• Difficulty talking
• Pale face
• Blue lips or fingernails
• Sweating
• Panic attacks or anxiety

How You Can Help Someone Having an Asthma Attack

Sometimes, asthma symptoms can be brought quickly under control with the use of a rescue inhaler. However, if the person does not have a rescue inhaler or is having significant trouble breathing, call 911 right away. Don't wait to see if it will get better on it's own—if breathing is completely cut off, an asthma attack can be fatal very quickly. Blue lips or fingernails, loud wheezing, rapid gulping for air, and loss of consciousness are indications that the person is running out of oxygen.

For milder attacks, get the person away from the source of exposure that triggered the attack and into fresh air. Make sure they use their rescue inhaler if they have one. If they are experiencing heightened anxiety or panic attacks, talk them through it. If their breathing does not quickly return to normal after removing the trigger and using the rescue inhaler, they should go to the emergency room or urgent care for an evaluation. A doctor may prescribe a nebulizer treatment to help them get their breathing under control.

Employees with asthma should monitor the frequency and severity of their symptoms and follow up with their doctor if asthma symptoms are not under control. Frequent use of a rescue inhaler indicates that additional proactive treatment may be needed.

Protecting Employees from Asthma Triggers in the Workplace

The most important step that employers can take to protect workers with asthma and prevent new cases of asthma from developing in their workforce is to keep indoor air as clean as possible. This may require reducing exposures to below the permissible exposure limits (PELs) set by OSHA.

Here are some steps manufacturers can take:

• Manufacturers who are unsure of their current exposure levels should get a third-party evaluation of their indoor air quality. A good understanding of current conditions is important when designing an air quality solution.
• Effective engineering and process controls should be used to reduce indoor exposures as much as possible. These can include housekeeping measures that prevent the spread of dust and ventilation or air filtration solutions to remove particulates from indoor air. Most manufacturers require effective source capture or ambient air filtration, or a combination of the two, to remove dust and fumes created by manufacturing processes from the air.
• If exposure levels cannot be brought within appropriate limits through engineering controls, provide personal protective equipment (PPE) such as powered air purifying respirators (PAPRs) to employees working in dust-intensive areas.
• Institute a medical surveillance program to look for asthma and other health issues that may be related to occupational exposures. High incidence of asthma and other respiratory problems in your workplace may indicate that additional work is needed to reduce exposure levels to potential triggers.

Working in Manufacturing with Asthma

Does this mean that people who already have asthma, or who develop it on the job, shouldn't work in manufacturing environments? Not necessarily. If manufacturers take the steps above to reduce occupational exposures, it is possible to create a safe working environment for all employees.

Manufacturing workers with asthma will want to take special care to protect themselves from potential triggers and monitor their symptoms on the job.

• Some workers with asthma may want to use PPE when exposure levels are below OSHA PELs but still high enough to be problematic for people with compromised respiratory systems. It is important to know that workers with asthma should never use negative pressure respirators; make sure they have a PAPRs system that provides powered assistance in pushing air into the breathing zone.
• Workers should also make sure that they always have a rescue inhaler on them while at work. (Companies may want to consider having extra over-the-counter rescue inhalers on hand in the company first aid kit.)
• Make sure workers have accurate information about occupational exposures to report to the doctor in charge of their care. Employees with asthma should see their doctors regularly to evaluate how well their asthma is controlled and make changes to their treatments.
• While employees have the right to keep their medical history private, workers with asthma may want to consider letting supervisors and close colleagues know so that they are more likely to recognize an asthma attack if one develops.

Asthma can be a challenge to control in manufacturing environments. But it doesn't have to mean the end of a manufacturing career. Employers who prioritize clean air can ensure that all workers are able to breathe easy.