According to a recent report from the CDC, 33,307 people between the ages of 15 and 64 died from asthma between 1999 and 2016. What caused those deaths? For an estimated 3,664-6,994 of them, an occupational exposure to a hazardous substance may have been to blame.
Men working in food, beverage, and tobacco products manufacturing; retail trade; and miscellaneous manufacturing were most often affected. For women, working in social services raised the risk.
Where we come in
How can respiratory therapists put a dent in these sobering statistics? Kathleen Clark, PhD, MS, RRT, CPFT, program officer for the National Institute for Occupational Safety and Health (NIOSH) Spirometry Training Program, believes RTs need to keep occupational exposures top of mind when working with their asthma patients.
“In the U.S., an estimated 3-7% of ‘new onset’ adult asthma can be attributed to workplace exposures,” Dr. Clark said. “Occupational asthma is difficult to identify because respiratory symptoms can take weeks or years to develop. Therefore, RTs should always consider workplace exposure histories when ‘symptom triggers’ are being discussed with adult asthmatics.”
Which exposures should therapists ask about? Dr. Clark says to include exposures to plant and animal allergens; chemicals in the workplace, such as adhesives, varnishes, or flavorings; and other respiratory irritants, such as smoke, metals, or toxic fumes.
Susan Blonshine, RRT, RPFT, AE-C, FAARC, president and CEO of TechEd Consultants, Inc., a network of clinicians specializing in pulmonary function testing, agrees RTs have a big role to play.
“Respiratory therapists are the initial health care professionals to interact with individuals in the emergency department,” she said. “Due to the acute and/or delayed impact of occupational exposures on the respiratory systems, RTs must be aware of the triggers associated with an acute exacerbation.”
She says if these occupational triggers are not properly identified, the worker may remain at significant risk for another acute exacerbation as exposure continues. Over time, chronic exposures could lead to an irreparable decrease in lung function.
“RTs have a significant opportunity to interact with workers, both as asthma educators and in the pulmonary laboratory,” Blonshine said. “They should know who and how to report workplace exposures in their community.”