Breathing in substances called respiratory sensitisers at work can cause occupational asthma.

A respiratory sensitiser is a substance which when inhaled can bring on an irreversible allergic reaction in the respiratory system. Once a sensitisation reaction occurs, continued exposure to the substance will produce symptoms.

Sensitisation does not usually take place right away but can happen after several months or even years of breathing in the sensitiser.

Substances responsible for most cases of occupational asthma include the following:-

Substance Groups & their Common Activities

Isocyanates:Vehicle spray painting;foam manufacturing

Flour/grain/hay:Handling grain at docks;milling, malting, baking

Glutaraldehyde:Disinfecting instruments

Wood dusts:Sawmilling, woodworking

Electronic Soldering Flux:soldering

Latex:Laboratory animal work

Some glues/resins:Curing of epoxy resins

The symptoms of respiratory sensitisation are:

– asthma – attacks of coughing, breathlessness and tightness of the chest

– rhinitis and conjunctivitis – runny or stuffy nose and watery or prickly eyes

Once a person is sensitised, symptoms can occur either immediately they are exposed to the sensitiser or several hours later. If the symptoms are delayed, they are often most severe in the evenings or during the night, so workers may not realise it is work that is causing the problem.

– If exposure to the substance continues, this can result in permanent damage to the lungs. People with rhinitis may go on to develop asthma.

– Respiratory sensitisers are regulated by the Control of Substances Hazardous to Health(CoSHH).

CoSHH guidelines recommend an assessment of the risks created by work which are liable to expose employees to respiratory sensitisers.

First, find out whether there is an activity or process in your workplace which uses or creates respiratory sensitisers.

If this is the case, then ask the following:

– Is the sensitiser likely to become airborne in use?

– Are there safer alternatives?

– Who is likely to be exposed, to what concentrations, for how long and how often?

According to CoSHH regulations, exposure must be prevented or controlled. To do this you will need to think about how you can:

– Stop using the sensitiser altogether perhaps by replacing it with a less harmful substance;

or if this is not reasonably practicable;

– Segregate work that may pose a risk; or totally end the process;

or if this is not reasonably practicable;

– Partially enclose the process and provide local exhaust ventilation.

If after carrying out the above you still have not achieved adequate control you will also need to use respiratory protective equipment (RPE).

Unless you are confident that your CoSHH assessment shows that there is an unlikely risk to your health, then a system of health surveillance will need to be set up if employees are exposed to respiratory sensitisers.

If health surveillance makes you suspect an employee has become sensitised you should:

– Remove the individual from working with the sensitiser and advise them to consult a doctor giving information on the work they do and the substances they may have been breathing in;

– Review your CoSHH assessment and existing control measures and make any necessary changes.

If employees are exposed to respiratory sensitisers then employers have a legal duty to inform, instruct and train them so that they know and understand:

– The risks to health;

– The symptoms of sensitisation

– The significance of reporting even possibly minor symptoms at an early stage;

– The proper use of control measures;

– The need to report promptly any failures in control measures

What’s the first thing that comes to your mind when you think about a career in the field of healthcare? Does your mind conjure up images of somber-looking doctors and nurses attending to one medical emergency after another? Or are you discouraged by the thought of going through years of extensive schooling?

Well, it’s time someone told you there is more to the healthcare profession than doctors and nurses. There’s a whole army of healthcare professionals who specialize in providing different kinds of patient care. What’s more encouraging is the fact that a lot of these professions don’t require extensive training or years of schooling.

Among these lesser known medical warriors are respiratory therapists or RTs. Respiratory therapists provide treatment, evaluation, and care to patients who are suffering from breathing or cardiopulmonary disorders.

They work with physicians in the cardiopulmonary or respiratory care department of a hospital, clinic, or home health services center. Among their many duties are:

Diagnosing breathing disorders.
Recommending appropriate treatment.
Conducting physical examination of patients.
Managing ventilators and other breathing devices.
Educating patients and their families about breathing disorders.

If you think becoming a Respiratory Therapist is your cup of tea, you need to start planning early. Maintaining good grades in biology, chemistry, physics, and math through high school could hold the key to becoming a Respiratory Therapist.

A strong foundation in these subjects will ensure that you sail smoothly through college. Although you can get started with an Allied Health degree, there are direct programs that train you specifically for a career in Respiratory Therapy and may be a good choice for interested candidates.

Two-year training programs leading to an Associate’s degree in Respiratory Therapy are offered by community colleges, career schools, hospitals, and the armed forces. An Associate’s degree comprises both classroom instruction as well as clinical training. In fact, clinical training is a very important component of any Respiratory Therapy program as it allows students to work in real life situations in a healthcare environment.

Although entry-level jobs can be attained with an Associate’s degree, a Bachelor’s degree in Respiratory Care indicates a higher level of expertise and may be necessary for professional growth as well as for accessing roles with greater complexity. A Bachelor’s Respiratory Care program also comprises courses in management and non-clinical aspects of healthcare.

Some of the topics you can expect to learn en route to becoming a Respiratory Therapist are Cardiopulmonary Pharmacology, Pulmonary Anatomy & Physiology, Airway Management, Microbiology & Decontamination, Respiratory Care Protocols, Mechanical Ventilation Management, etc. Respiratory Therapists require a license from the National Board for Respiratory Care (NBRC) to practice in all U.S. states except Alaska and Hawaii. The board offers two types of credentials:

Certified Respiratory Therapist (CRT): This license is offered to RTs who graduate from accredited entry-level or advanced programs and also pass a licensure examination.

Registered Respiratory Therapist (RRT): This license is offered to CRTs who graduate from an advanced accredited program and pass two separate examinations. RTs who desire supervisory positions require an RRT.

In addition to these NBRC-conferred licenses, all practicing respiratory therapists need to obtain and maintain a certification in cardiopulmonary resuscitation (or CPR). Once you have the desired qualifications and necessary licensure, you can explore employment possibilities in a wide range of healthcare settings.