Occupational Asthma in the Kenyan Workplace

Published on 20th May 2011

Carpets are key to air quality   Photo Desso
Modern evidence suggests we cannot separate our working lives from the working environment.  We respond instinctively to our surroundings at a human level and if those surroundings fail to meet our basic needs, we can be made sick by them.  It even has a name: Sick Building Syndrome (SBS).

The World Health Organisation (WHO) officially recognised it as a health issue over twenty years ago.

It’s a complex problem responsible for a variety of conditions from respiratory infection to fatigue, causing illness, absenteeism, staff turnover and low morale.  It’s a hidden epidemic caught from the fabric of the buildings within which we live or work.

So significant is the problem of SBS that it’s estimated that, in some countries, up to 30% of all offices, hotels, institutions and industrial premises suffer from it – particularly those buildings that date back thirty years or more.

There are of course many causes for SBS, from inadequate lighting to poor air conditioning.  However, one of the main causes of SBS is the quality of indoor air, and one manifestation of that is occupational asthma, which makes up around 15% of all adult-onset asthma cases in the developed world.

Putting that in context, occupational asthma is the most common work-related lung disease in developed countries and is caused by occupational exposure to airborne substances known as asthmagens.  Over 200 respiratory sensitisers have already been classified and others are being identified all the time.

Across the world, the incidence of asthma is on the increase as more people adopt western lifestyles and become exposed to greater numbers of asthmagens.  Internationally, there are an estimated 300 million asthma sufferers and, according to the World Health Organisation, some 250,000 people died from asthma worldwide in 2005 alone.

It’s estimated that in Kenya some 10% of children between the ages of 10 and 14 have asthma, although the condition is often undiagnosed, and it is acknowledged that lung diseases are a major cause of morbidity and mortality in Kenya.

The most important risk factors for developing asthma are a combination of genetic predisposition and environmental exposure to inhaled substances and particles that may provoke allergic reactions or irritate the airways - everything from pollen and dust mites to animal dander and adhesives.  Miniscule dust particles settle in the lungs, and the smallest particles can end up in the bloodstream – with potentially serious consequences.

It’s an important issue for both employees and their employers.  For example, in the UK – which tops the world for asthma incidence - in 2008/09 up to 1.1 million working days were lost due to breathing or lung problems with an annual estimated cost of £2.3 billion.  According to the UK’s largest trade union, Unite, one third of people with occupational asthma are unemployed after diagnosis, a figure that remains roughly the same even after six years – at considerable human cost.

It’s the reason why health and safety regulations relating to indoor air quality have become increasingly stringent across the developed and developing world, with sufferers of occupational asthma having greater access to legal redress and financial compensation from their employers.  For today’s employers, it’s about recognizing and dealing with the problem because many jurisdictions now make it unlawful in codes of employment to discriminate against asthmatics.

However, damage to individual employees could be greatly reduced and costs for employers largely avoided by adopting appropriate preventative and control strategies, and by the early identification of individuals within the workplace suffering from pre-existing asthma or potentially suffering from occupational asthma.

Prevention and control starts with a workplace assessment to identify potential asthmagens and, thereafter, an exchange of views between the employer, employees and workplace health and safety professionals on appropriate strategies to minimize or eliminate exposure – for example, installing a better ventilation system or placing dangerous chemicals in a fume cupboard.  At its simplest, apart from an absolute ban on indoor smoking, dust, chemicals, perfumes and air fresheners are the most likely to cause problems – and those can be easily addressed.

Some employers now have guidelines to ensure their own offices are safe for asthma sufferers – for example, asking staff not to wear perfume or aftershave at work, to use unscented soaps, deodorants and hair products and not to smoke immediately before coming into the office.  Those guidelines also require non-volatile cleaning products and unscented air fresheners to be used.

However, in those instances where a significant risk is identified, continued health surveillance might also be required, involving a programme of spirometry [lung function] testing, to detect early indications of disease and provide appropriate medical advice to individual employees.

Early detection is important in occupational asthma, because people spend so much time at work – one estimate suggests that a person in a full-time office job will spend up to 1,800 hours a year in their office – that they will have had extensive exposure to their trigger by the time their symptoms become apparent and a diagnosis of asthma is made.

Put starkly, the more time you spend exposed to your asthmagen, the more likely you are to have permanent lung inflammation and airway hypersensitivity.  That’s why it’s important for employees to raise issues of indoor air quality or, more pertinently about occupational asthma, at the earliest opportunity.  For existing sufferers from asthma, it’s equally important that their employer and colleagues know about their condition, what triggers it, and what to do if they have an asthma attack.

But while it’s impossible to protect all employees from all possible asthmagens, the growing importance of work-related asthma with its associated duty of care from employers, means that the role of health and safety professionals continues to change – not only in monitoring indoor air quality but in providing the best possible overall environment for staff.

That environment starts from the floor because, among others, the German asthma foundation (DAAB) has for some time advised that the harmful effects of particulate matter can be greatly reduced if carpeting is chosen over hard flooring options.

At Desso, we’ve gone a step further by introducing a carpet type that is eight times more effective in capturing and retaining fine dust than hard flooring – and four times more effective than standard carpeting. (1)   It works by reducing the incidence of potentially harmful allergy-producing particles by safely trapping and immobilising them, guarantees a significant improvement in indoor air quality, and therefore reduces the risk of health-related problems.

AirMaster® was developed to improve indoor air quality in busy interior environments such as schools, hospitals and offices – anywhere where there is a lot of feet treading in dust or other particulate matter and then, when inside, stirring it up into the breathing zone.

It might seem an unusual weapon in the battle for better air quality, but it’s been extremely well received internationally by health and safety and personnel professionals who not only recognise the regulatory responsibilities on maintaining good indoor air quality, but the potential legal and other penalties if they don’t.

What’s on the floor might not be a complete solution to occupational asthma, but it can help considerably.

By Andrew Sibley,

Regional Sales Director, Desso.

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