Asthma that clocks in with you
Occupational asthma is asthma caused or triggered by something inhaled at work. The airways become inflamed and twitchy — hyperresponsive — so they narrow in response to a substance that does not bother most people. Hundreds of workplace agents can do this, from flour dust in bakeries and isocyanates in spray-painting to animal proteins, wood dust, and cleaning chemicals.
The most useful clue is timing. Symptoms — wheeze, cough, chest tightness — get worse across the working week and ease on weekends or holidays, then flare again on return. A close cousin is byssinosis, or 'Monday fever', the chest tightness cotton-mill workers feel on the first day back after a break.
Catching it early matters most
Occupational asthma is one of the few lung diseases where the cure can be straightforward — but only if it is caught early. In the first months, removing the worker from the trigger often leads to full recovery.
- Recognise the pattern: link symptoms to the workplace and the work week.
- Confirm it: serial peak flows, spirometry, and sometimes specialist challenge testing.
- Remove the exposure: relocate, control the agent, or change the process — the most important step.
- Treat and protect others: inhalers as for ordinary asthma, plus reviewing co-workers who breathe the same air.
The wider air: pollution and the home
Even people who never set foot in a dusty workplace breathe a shared atmosphere. Air pollution from traffic, industry, and burning is now recognised as a major driver of lung disease worldwide. The chief villain is particulate matter — and size matters: the finest particles (PM2.5) are small enough to reach the alveoli and even cross into the blood.
For billions of people the worst air is indoors: biomass smoke from cooking and heating with wood, dung, or charcoal in poorly ventilated homes. It is a leading cause of COPD in women who have never smoked. A different, invisible indoor hazard is radon, a natural radioactive gas that seeps from the ground into buildings and is, after smoking, the second leading cause of lung cancer.