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Respiratory Health Surveillance

Respiratory Health SurveillanceRespiratory health surveillance is a programme of regular, periodic spirometry testing (lung function testing) to detect an employee’s symptoms early enough and reduce their exposure, thereby reducing their risk of developing full-blown asthma or other occupational respiratory diseases.


The following sections place respiratory health surveillance in the context of an integrated risk management process.

Hazards

A respiratory sensitiser is a substance which when breathed in, can trigger an allergic reaction in the respiratory system. Initial sensitisation does not usually take place immediately, it happens after a period of perhaps weeks or months inhaling the sensitiser. Respiratory sensitisers have the following risk phrase and number in chemical safety data sheets

R42 ‘May cause sensitisation by inhalation’ (may lead to asthma),

R42/43 ‘May cause sensitisation by inhalation and skin contact’

 

See Table of respiratory hazards at end of page

Risk to Health

Occupational Asthma

Asthma is a chronic inflammatory disease of the airways. Common symptoms include wheezing, coughing, chest tightness, and shortness of breath.

Occupational Asthma is caused by, or made worse by, substances that are breathed in at work, e.g. wood dust, stone dust, poultry dust or fumes, animal dander.

Extrinsic allergic alveolitis (Hypersensitivity pneumonitis), is an inflammation of the alveoli within the lung caused by hypersensitivity to inhaled organic dusts, such as:

Mouldy hay and straw Farmer’s lung
Bird excreta and bloom Bird fancier’s lung
Mouldy barley Malt worker’s lung
Mushroom spores Mushroom workers lung
Cheese Mould Cheese worker’s lung


Chronic obstructive pulmonary disease (COPD)

COPD is a chronic illness that makes breathing difficult due to shortness of breath. COPD is a slow developing condition, the symptoms tend only to start becoming a problem in mid-life. Smoking is the main cause of COPD, but research has linked exposure of specific substances and specific occupations with a higher risk of causing COPD

Legislation

Health and Safety at Work (Chemical Agents) regulations 2001 and Guidelines on occupational asthma HSA 2007

Risk Assessment

Carrying out a risk assessment for airborne hazardous substances in fume, dust, gas or mist present in the breathable air is highly specialised. You will need to commission an occupational hygienist to identify what substances are present in the work environment and to measure the concentration of these substances in the air.

Several Hazardous substances have Workplace Exposure Limits (WELs) which establish safe exposure limits. Refer to the H.S.A. web-site for detailed information.

Exposure measurement’ requires a survey to assess people’s exposure to substances in workplace air, and discover how and why this exposure happens.

Personal sampling’ is taking an air sample near the worker’s breathing zone to measure the amounts of airborne substances inhaled for a stated task.

The air monitoring program information will guide your implementation of risk control measures.

Hierarchy of Risk Controls

Control measures are what steps you are going to take to remove a hazard (eliminate) or at least reduce it to a low level (minimise).

Hiearchy of Noise Controls

Respiratory Health Surveillance program

Respiratory health surveillance consists of:

Respiratory health questionnaire
Spirometry (Lung Function Testing)

The Questionnaire gathers information on whether common symptoms of respiratory ill-health such as coughing, wheezing, nasal irritation, difficulty in breathing, tightness of chest are present, and the possible relationship of these symptoms to the workplace.

Lung Function Testing

A lung function test is done with a spirometer. Normal spirometry results are based on the age, height, and gender of the person being tested and most are expressed as a percentage of a predicted value.

Spirometry results are expressed as a percentage, and are considered abnormal if less than 80 percent of the normal predicted value. An abnormal result usually indicates the presence of some degree of obstructive lung disease such as asthma, emphysema or chronic bronchitis, or restrictive lung disease such as pulmonary fibrosis.

MedWise Mobile Medicals provide a complete respiratory surveillance service from on-site spirometry testing, result analysis, specialist occupational health physician review of results, site summary report and multi-year trending and reporting.

Table of Respiratory Hazards

Sector or Activity

Respiratory Hazard

Respiratory Health Risk

Agriculture

Straw Dust (Fungal Spores)

Grain Dust

Occupational asthma

COPD chronic obstructive pulmonary disease

extrinsic allergic alveolitis,

(farmer’s lung)

Paint Spraying

Isocyanate (typically in 2-pack paints)

Occupational asthma.

Baking

Flour Dust

Occupational asthma

Extrinsic allergic alveolitis (Bakers Lung)

Construction / Quarries

Respirable crystalline silica (RCS) is found in stone, rocks, sands and clays

Exposure to RCS over a long period can cause fibrosis (hardening or scarring) of the lung tissue with a consequent loss of lung function.

Cement working

Potassium dichromate

Occupational asthma

Electroplating

Nickel plating

Inhaling mist containing nickel sulphate and nickel chloride

Occupational asthma.

Mushroom Growing

Mushroom Spores

Extrinsic allergic alveolitis.

Mushroom worker’s lung


Mushroom picker’s lung or

mushroom picker’s asthma.


MetalWork

Metalworking Fluids are mineral oils or water-based fluids used during the machining metals to provide lubrication and cooling.

occupational asthma,

bronchitis,

irritation of the upper respiratory tract,

extrinsic allergic alveolitis

Poultry

Poultry Dust

Occupational asthma

Soldering

Rosin based solder flux fume

Occupational asthma

Welding

Welding Fume

(gases and very fine particulate)

Lung infection, Pneumonia, Occupational asthma, cancer, metal fume fever

Woodwork

Wood Dust produced when wood is machined or sanded.

Occupational asthma

PVC Processing Workers

Packaging

Moulding

Extrusion

Polyvinyl chloride vapour

Occupational asthma

Adhesives containing Acrylates

Acrylates are the salts, esters, and conjugate bases of acrylic acid and its derivatives.

Occupational asthma

Animal Workers

Animal fur, feathers, dander, dried urine and saliva dusts arise through animal handling and cage or enclosure cleaning.

These dusts contain proteins, 'animal aeroallergens’ that cause occupational asthma.

Occupational asthma

Plastics and Foam Industry Workers

Di-isocyanates are used in the production of polyurethanes

Occupational asthma