A worker’s respiratory tract can come into contact with about 14,000L of air during a 40-hour working week – and physical activity will increase their breathing rate even more. Therefore, the quality of the air we breathe at work can have major implications for a worker’s respiratory health.
Any part of the respiratory tract, from the nose down to the alveoli (the tiny air sacs in the lungs), can be affected by airborne contaminants. The part of the respiratory tract affected depends on:
Airborne contaminants may be dusts, gases, vapours, or fumes.
Inhalation of airborne contaminants may immediately injure the respiratory tract and cause acute symptoms, such as shortness of breath, cough and chest tightness, and require emergency medical care – or it could lead to prolonged symptoms due to the development of irritant induced lung disease.
The extent of injury will depend on the type and dose of exposure.
Upper respiratory tract disorders | ||
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Disease category | Representative causative agent (Allergen) | Symptoms and further info |
Nonspecific irritation | Irritant gases (eg ammonia; chlorine), fumes, dust | Symptoms include cough, nasal irritation and congestion |
Rhinitis (allergic and non-allergic) | Pollens, animals, house dust mites, various chemicals |
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Upper airway dysfunction (vocal cord dysfunction, work associated irritable larynx syndrome) | Chemicals with a high water solubility, alkaline and acids gases, dust and mists |
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Airway disorders | ||
Disease category | Representative causative agent (Allergen) | Symptoms and further info |
Occupational asthma - Sensitiser induced asthma / Reactive airways dysfunction syndrome | Currently there are over 400 known respiratory sensitising agents (substances that cause an allergic asthmatic response) Examples include:
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Occupational asthma - Irritant induced asthma | Examples include:
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Reactive airways dysfunction syndrome (RADS) | Irritant gases, corrosive mists or solvent vapours |
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Work exacerbated asthma | Irritants (eg cotton dust), fumes, exertion, cold air, emotion |
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Chronic bronchitis / chronic obstructive pulmonary disease (COPD) | Irritants, mineral dust, coal, welding fumes, organic dusts, grain and flour dusts |
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Byssinosis | Inhalation of cotton dust, or dusts from other vegetable fibres (such as flax, hemp and sisal) |
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Bronchiolitis | Noxious chemicals such as oxides of nitrogen, Diacetyl (‘popcorn worker’s lung’) |
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Acute inhalation injuries | ||
Disease category | Representative causative agent (Allergen) | Symptoms and further info |
Toxic pneumonitis | Inhalation of metal fumes, or toxic gases and vapours |
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Metal fume fever | Metal oxides, oxides (zinc, magnesium, silver, gold, beryllium, cadmium, cobalt, copper, etc |
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Smoke inhalation | Combustible products (carbon monoxide, oxides of nitrogen, formaldehyde, hydrogen cyanide, etc) Smoke particulate containing absorbed irritants and carcinogenic polycyclic aromatic hydrocarbons (PAHs) |
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Malignancies | ||
Disease category | Representative causative agent (Allergen) | Symptoms and further info |
Sino-Nasal Cancer | Wood dust | Often, there may be a period of latency (inactivity) between the actual exposure and the development of disease, which might take decades. However, the inhalation of radioactive materials can induce sino-nasal and lung cancer reasonably rapidly. |
Lung Cancer | Asbestos, radon, silica dust | |
Mesothelioma | Asbestos | |
Further respiratory injuries and illness | ||
Disease category | Representative causative agent (Allergen) | Symptoms and further info |
Hypersensitivity pnueumonitis | Bacteria, fungi, animal and plant proteins |
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Infectious disorders | Bacteria (eg legionella), pneumonia, tuberculosis, viruses | More information can be obtained from NSW Health and Dept of Primary industries. |
Pneumoconiosis | Asbestos, silica, coal | Often, there may be a period of latency (inactivity) between the actual exposure and the development of disease, which might take decades. There are very rare cases where pneumoconiosis can be relatively rapid and take a year or less. |
Non-specific building related illness (‘Sick building syndrome’) |
| The main identifying observation is an increased incidence of workers reporting symptoms such as headache, eye, nose, throat irritation, fatigue, dizziness and nausea. |
Adapted from RACGP website article, “Respiratory problems”; Occupational and environmental exposures; Volume 41, No.11, November 2012 Pages 856-860 (initially adapted from Fishman AP, editor. Fishman’s Pulmonary Diseases and Disorders. 4th edn. New York: McGraw Hill, 2008)
Failure to correctly manage workplace respiratory hazards may put workers at risk of exposure to these preventable occupational diseases. It can also lead to an at-risk worker suffering ongoing respiratory difficulties, the need for higher doses of medication and a substantial, possibly irreversible, decline in lung function and associated disability.
It is important that there is communication between the PCBU, worker, treating physician and health and safety representative (where applicable) to ensure respiratory hazards and conditions, whether pre-existing or otherwise, are effectively managed.
Where necessary, consult with building managers and other relevant parties – it’s more likely that suitable, long term solutions to the problem can be found when everyone works together.
In complex situations, PCBUs should establish a clearer picture of the issue by obtaining the services of an appropriately qualified person (such as an occupational hygienist with skills in air quality) and then appropriate control measures can be developed in consultation with the affected workers. In these situations, the workplace conditions may need to be monitored and recorded as part of the workplace risk management program.
Effective control and management of respiratory conditions, including asthma, starts with recognising potential sources.
Identify workplace activities that may put someone at risk of exposure. Talk (consult) with all of your workers about anything that could result in them being exposed to a respiratory illness. Analyse workplace incident reports. Check audits of the workplace layout and work practices. There may be a need for a competent person such as an occupational hygienist to assist in the identification process.
Consider who is at risk. Do you have any workers with pre-existing respiratory conditions?
To assess the risks of exposure to a respiratory illness, take into account:
To control the risks, follow the hierarchy of controls as much as possible. Use higher level controls first. Only use administrative controls and PPE to supplement the higher controls you’ve implemented. A combination of controls can be used.
To reduce the number of people exposed:
Administrative controls and personal protective equipment should be part of a comprehensive control program – not the sole strategy for reducing exposure to respiratory hazards.
Administrative controls don’t remove the hazards - they limit or prevent people's exposure to them, and can include:
Work health assessments determine existing conditions, capabilities or other factors that could pre-dispose a person to possible ill-health by matching their physical and mental capabilities to the requirements of a specified task/s.
Everyone – the worker, PCBU and treating doctor – is a key participant in this process and has an important role to play in achieving a successful outcome from the health assessment.
Work health assessments can be carried out:
There is no ‘one size fits all’ approach – work health assessments should involve specific tests and screening required for the identified respiratory hazards at the PCBUs workplace, such as spirometry and lung function tests.
SafeWork NSW recommends that, as far as is reasonably practicable, work health respiratory assessments are done by an occupational physician. Referral to a physician will assist with further investigations, establishing a diagnosis and developing a workplace respiratory management plan if required.
The physician should obtain information from the PCBU about the workplace, such as identified hazards; required tasks; length of shifts; current controls in place; etc. It is highly recommended the physician visits the workplace to obtain direct and visual information for their assessment. If the worker is asthmatic the physician should also review the worker’s inhaler technique and adherence – and, if poor, advise how to correct and/or improve it.
When the results of the worker’s health assessment is known, it is vital that the worker, their PCBU and physician / treating doctor work closely together to develop a workplace asthma management plan for the worker that includes strategies to reduce exposure to workplace triggers and irritants.
SafeWork NSW acknowledges that in many areas of NSW, it can be difficult to access to such specialists in a timely manner. The Thoracic Society of Australia and New Zealand (TSANZ) and the Australasian Faculty of Occupational and Environmental Medicine (AFOEM) can provide assistance in locating specialists.
Workplace respiratory management plans, including workplace asthma management plans should document specific advice for both the worker and PCBU about how to effectively manage the respiratory condition at the workplace, and should include:
The PCBU should frequently talk with the worker about their respiratory condition to ensure the plan is effective. These discussions may be required more frequently for workers undertaking new tasks; working in new areas; or during changing weather conditions (outdoor workers).
A copy of the worker’s workplace respiratory management plan should be provided to the Safety Officer, first aid officer and Health and Safety Representatives (where applicable).
Workplace asthma emergency kits help to manage asthma flare-ups in the workplace.
They should be located throughout the workplace in high-risk areas. They can also be located in a ‘bum-bag’ worn by first aiders, to be more mobile and easily accessed in an emergency.
The contents of these kits should be as recommended by Asthma Australia and should include:
Ensure there is an effective system in place to regularly check that the contents of each kit is in-date, undamaged and ready for use.
Don't ignore symptoms or delay seeking help - prompt action is required.
Website: http://www.health.nsw.gov.au/Pages/default.aspx
Phone: (02) 9392 9000
Website: https://www.aioh.org.au
Phone: (03) 9338 1635
Website: https://www.thoracic.org.au
Phone: (02) 9222 6200
Website: https://www.racp.edu.au
Phone: (02) 9256 5444
Website: https://www.asthma.org.au
Phone: 1800 ASTHMA (1800 278 462)
Website: http://www.dpi.nsw.gov.au
Phone: (02) 6391 3100