Topic List

  • Topics
    • Epi Manual
      • Titles and Introductions
      • Laws & Quarantine Orders
      • General Contact Info.
      • Reportable Disease Info.
      • Reportable Diseases A - B
      • Reportable Diseases C - D
      • Reportable Diseases E - F
      • Reportable Diseases G, H, I
      • Reportable Diseases J, K, L
      • Reportable Diseases M - N
      • Reportable Diseases O - P
      • Reportable Diseases Q - R
      • Reportable Diseases S - T
      • Reportable Diseases U, V, W
      • Reportable Diseases X, Y, Z
      • Information on Other Diseases and Conditions
      • Environmental Disease
        • Contact Information
        • Ag/Farm Injury Report Form
        • Asbestosis
        • Cadmium Poisoning
        • Carbon-Monoxide Poisoning
        • Coal Workers Pneumoconiosis
        • Hypersensitivity Pneumonitis
        • Lead Poisoning
        • Mercury Poisoning
        • Methemoglobinemia
        • Microcystine
        • Occupationally Related Asthma, Etc
        • Organic Dust Toxic Syndrome
        • Pesticide Poisoning
        • Severe Skin Disorder
        • Silicosis
        • Silo Filler's Disease
        • Toxic Hepatitis
        • Arsenic Poisoning
      • Appendices
      • EPI Manual Historical Revisions
    • Foodborne Outbreak Investigation

Topic Content

Occupationally Related Asthma, Etc


Occupationally related asthma, bronchitis, or respiratory hypersensitivity reaction is an inflammation of the lungs (pneumonitis) or breathing difficulty caused by inhalation of noxious chemicals.

A. Clinical Description

Acute chemical pneumonitis causes swelling of the lung tissue, movement of fluid into the air spaces in the lung, and less ability to absorb oxygen and get rid of carbon dioxide.  In severe cases, death may result from lack of oxygen reaching the tissues (hypoxia).  Chronic chemical pneumonitis can follow low levels of exposure to the lung irritant over extended periods.  This causes inflammation and may provoke fibrosis (scarring) with decreased oxygen exchange and stiffening of the lung.  Unchecked, this condition may ultimately lead to respiratory failure and death.

Symptoms of acute exposure include an unusual feeling, possibly a feeling of burning in the chest, difficulty breathing, coughing, and abnormal lung sounds.  Symptoms of chronic exposure include shortness of breath with only mild exercise, rapid breatthing, cough, and progressive disability related to shortness of breath. 

B.  Sources of Exposure

Many household and industrial chemicals can produce both an acute and a chronic form of inflammation in the lung.  Chlorine is one of the most irritating of commonly inhaled substances.  Exposure to dangerous levels may occur at home (during use of cleaning materials such as chlorine bleach), in industrial accidents, or near swimming pools. Inhalation of dangerous substances can occur in many different settings, including factories (especially during smelting, welding, or other metal work), the production or use of solvents or pesticides, fires (house fires, wildfires), and the handling of grain.

C. Population at Risk

The primary population at risk are those who work with chemicals in an occupational setting. 

D. Diagnosis, Treatment, and Prognosis

Diagnosis is made by taking an occupational exposure history and through a chest x-ray, lung function studies, and blood-gas analysis. 

The most important treatment is to stop the exposure to the chemical that caused the symptoms.  Further teatment is focused on reducing symptoms.  Oygen therapy may be helpful, and corticosteroids may be given to reduce inflammation.

The outcome depends on the chemical agent involved, the severity of exposure, and whether the problem is acute or chronic.  Respiratory failure and death can occur.

E. Prevention of Exposure

Work rules on breathing masks should be followed, and the appropriate breathing mask should be worn.  People who work near fires should take care to limit exposure to smoke or gases.

A. Disease Reporting

Occupationally related asthma, bronchitis or respiratory hypersensitivity reaction, including any extrinsic asthma or acute chemical pneumonitis due to exposure to toxic agents in the workplace (ICD-10 codes J67.0-J67.9), must be reported to the Iowa Department of Public Health by the physician or other health practitioner attending the patient and by laboratories performing tests identifying reportable diseases.  Reports are made to the Division of Environmental Health at 800-972-2026. 

B. Reference