Workplace Asthma Often Overlooked

By Andrew Sibley

Sick building syndrome (SBS) was officially recognized as a health issue by the World Health Organisation (WHO) more than 20 years ago. It causes a variety of illnesses and conditions from eye, nose and throat irritation, headaches, dry cough, dry or itchy skin, dizziness, nausea, difficulty concentrating, fatigue and sensitivity to odors, according to the Environmental Protection Agency (EPA).

SBS is a hidden epidemic with a very real human cost. We can’t avoid going to work, and Americans spend more than 90 percent of their time indoors. So prevalent is the problem that the EPA estimates SBS costs businesses approximately $60 billion annually.

While SBS can have a number of causes from poor lighting to badly maintained air conditioning, the main causative factor is the quality of indoor air. The WHO estimates that 30 percent of buildings in the United States may experience indoor air quality problems.

That adds up to a heavy burden of illness, with one specific manifestation being the growing incidence of occupational asthma, a form of asthma caused by our place of work. Overall, asthma affects 25 million people in the United States, and the EPA reports approximately 13 million people have reported having an asthma attack in the past year.

Scope of the Problem

The number of people diagnosed with asthma in the United States grew by 4.3 million from 2001 to 2009. In 2007, asthma was linked to 3,447 deaths, approximately nine per day. Asthma costs grew from approximately $53 billion in 2002 to $56 billion in 2007, a 6 percent increase.

In the workplace, an estimated 11 million workers in a wide range of occupations are exposed to at least one of the numerous agents known to be associated with occupational asthma. OSHA reports that occupational factors are associated with up to 15 percent of disabling asthma cases in the United States.

Indeed, occupational asthma is the most common work-related lung disease in developed countries. It is caused by occupational exposure to airborne substances known as asthmagens. More than 200 respiratory sensitizers have already been classified and others are being identified all the time. That’s why health and safety regulations relating to indoor air quality have become increasingly stringent across the developed and developing world, with sufferers of occupational asthma having greater access to legal redress and financial compensation from their employers. Today’s employers must recognize and manage the problem, because businesses that discriminate against asthmatics can run afoul of the law.

Oversight and Regulatory Activity

The Air Pollution and Respiratory Health Branch of the National Center for Environmental Health, Centers for Disease Control and Prevention (CDC) leads the fight against environmentally related respiratory illnesses, including asthma, and studies indoor and outdoor air pollution.

CDC’s asthma program focuses on three main activities: collecting and analyzing data, implementing scientifically proven interventions to reduce the burden of asthma, and establishing partnerships to develop, implement and evaluate local asthma control programs.

OSHA has responsibility for indoor air quality. Employers are required to follow the General Duty Clause of the Occupational Safety and Health (OSH) Act, which requires them to provide workers with a safe workplace that does not have any known hazards that cause or are likely to cause death or serious injury.

The OSH Act also requires employers to obey occupational safety and health standards created under it. Employers should be reasonably aware of the possible sources of poor air quality and should have the resources necessary to recognize and control workplace hazards. It is also their responsibility to inform employees of the immediate dangers that are present. In addition, specific state and local regulations may apply.

Under the OSH Act, any employee has the right to contact an OSHA office and request a workplace inspection. A worker can also tell OSHA not to let their employer know who filed the complaint. It is against the OSH Act for an employer to fire, demote, transfer or discriminate in any way against a worker for filing a complaint or using other OSHA rights. However, damage to individual employees can be greatly reduced and costs for employers largely avoided by adopting appropriate preventive and control strategies and by the early identification of individuals within the workplace suffering from pre-existing asthma or potentially suffering from occupational asthma.

As a first, employers should examine The National Institute for Occupational Safety and Health’s (NIOSH) eight-point plan for IAQ. It includes guidance on designating an IAQ manager and an IAQ profile of their premises, to developing, implementing and monitoring its effectiveness. View the plan at


Start with a workplace assessment to identify potential asthmagens. Engage with employees and management about appropriate strategies to minimize or eliminate exposure. For example, install a better ventilation system or place dangerous chemicals in a fume cupboard. Limit employee exposure to dust, chemicals, perfumes and air fresheners. Fortunately, these are easily addressed.

If a significant risk is identified, continued health surveillance might also be required, including a spirometry program to test employee lung function. That will assist safety professionals in detecting disease early and provide appropriate medical advice to individual employees.

Because people spend so much time at work, early detection of occupational asthma hazards is important. One estimate suggests that a person in a full-time office job will spend up to 1,800 hours a year at their place of work and will have had extensive exposure to their trigger by the time their symptoms become apparent and a diagnosis of asthma is made.

Assess the Environment

The duty of care from employers to protect employees from occupational asthmas means that the role of health and safety professionals continues to change. That must monitor IAQ and provide the best possible overall environment for staff.

That environment starts from the floor. Research groups such as the German Asthma and Allergy Foundation (DAAB) advises that the harmful effects of particulate matter can be greatly reduced if carpeting is chosen over hard flooring options.

Today, carpet types are available that are eight times more effective in capturing and retaining fine dust than hard flooring and four times more effective than standard carpeting. New technology allows certain carpeting to reduce the incidence of potentially harmful allergy-producing particles by safely trapping and immobilizing them. That results in a significant improvement in IAQ and therefore reduces the risk of health-related problems.

In addition to flooring, consider heating and ventilation filters, fumes from work processes and outdoor air pollutants that may be contributing to workplace asthma. A single factor may not be a complete solution to occupational asthma, but a thorough evaluation of asthmagens can help considerably.

Additional information on workplace asthma can be found in the following resources:

Andrew Sibley is with Desso, a European carpet manufacturer. Desso has adopted Cradle to Cradle design principles. In the United States, projects seeking certification under the LEED Green Building Rating System can earn up to four “Innovation in Design” points using Cradle to Cradle certified products. For more information, visit