In this section, Common Asthma Triggers, we have included the most common triggers found almost anywhere and everywhere. Once an individual has identified the irritants and allergens that can worsen his or her asthma symptoms, it will gradually become second nature to anticipate and recognize the presence of triggers in various environments encountered in everyday living. Allergy skin testing is often very helpful to identify allergens and the results can be a useful tool to facilitate change. Your advice and support can help your patient learn what avoidance and management strategies work best for him or her. Knowledge and experience will guide your patient’s decisions. Know that this is a process that takes time but patience and perseverance will lead to greater awareness and better controlled asthma.
Asthma Triggers in Schools
The school environment can present many challenges to students, teachers, other personnel and parents/guardians. For children and youth with asthma, school is probably the most important environment apart from their home. Exposures at school can lead to worsening asthma, social isolation and increased absenteeism. Asthma is the leading cause of school absenteeism attributable to a chronic disease. In this section, Asthma Riggers in Schools, we have included the most common triggers of asthma in the school environment and suggested some avoidance strategies. Since asthma can be triggered by allergens or irritants indoors and/or outdoors at school, we have organized the section in two parts. Asthma management is improved when health care providers, students, parents and school personnel work together to identify, eliminate and control triggers. Increased awareness and collaboration are positive steps toward creating “asthma friendly” schools.
Work-Related Asthma (WRA) is the most common chronic work-related respiratory disease in Canada and is responsible for an estimated ten to fifteen per cent of new onset adult asthma. Work-related asthma is defined as: asthma caused by exposure to an agent found in the workplace according to the Canadian Thoracic Society Guidelines. WRA can be classified into two categories:
- true “occupational asthma” which is a term resented for asthma caused by an exposure in the workplace.
- “work aggravated” asthma which is a term used to describe pre-existing asthma worsened by workplace exposure.
Identifying and diagnosing WRA can be a challenging experience for health care providers. It is important to identify if asthma symptoms are worse during working weeks than during periods off work such as holidays. If so, then a physician assessment is needed to start investigations for possible work-related asthma. In this section, Work-Related Asthma, we have organized the information in a simple format. There is no way to avoid long lists of agents that most of us cannot pro-bounce or begin to understand, but we think you will find it easy to use this guide by first identifying the occupation and/or industry where your patient works. From there the lists are narrowed down to include the most common triggers in that work-place environment. You and your patient can do some initial work to see if any of the listed agents are known to be present in his or her workplace.
Once WRA is suspected, there are many tools and programs in the workplace and community to assist you. Workplace Hazardous Materials Information System (WBMIS) is a legislated program that requires labelling of containers of controlled products and the provision of a material safety data sheet (MSDS) with each product. Patients should be encouraged to refer to the MSDS information to assist in the identification of potential triggers. The most important management ‘recommendation is to have an early and thorough medical assessment to confirm or exclude a diagnosis of work-related asthma if this is suspected. This almost always involves a referral to a specialist in work-related asthma. Early identification of occupational sensitizers and the removal of sensitized patients from any further exposure are also important aspects to the management of work-related asthma. Your patient can facilitate the process of identification and diagnosis by providing as much information as possible.