What to do if you think your asthma is work-related

• Try to confirm the link
• Plan prevention measures
• Investigate compensation
• Campaign to reduce the risk of occupational asthma

Confirming the link

The first step is to use a peak flow meter (available on prescription) to see how your breathing changes during the working week and when away from work. You will need help to interpret the results; contact SOHAS or your practice nurse for instructions and help.

Your GP can refer you to a chest specialist for further investigations. This is particularly useful if your asthma is not responding to treatment, or the pattern is unclear, or you are planning to leave work because you think that your asthma is work-related.

How to test your lungs

Workers can get a good indication of the effect of workplace factors on their lungs using a peak flow meter.

Lungs which have not been too badly damaged by chemicals show a tell-tale response when confronted with a sensitiser. The lungs recover over a weekend or break period; a reading will be characteristically high on a Monday morning. It will continue to drop through the week, only recovering again at the weekend. There will tend to be a time lag between exposure and onset of symptoms.

The effects of exposure to irritants will not offer so clear an exposure “fingerprint”. There will usually be a more instantaneous effect, with symptoms directly following an exposure to a lung irritant.

Another essential step is to establish what you have been exposed to at work. The substances at work may have a warning (a ‘risk phrase’) on them or you may need to get advice on the effects of the chemicals mentioned:

• R20 Harmful by inhalation
• R23 Toxic by inhalation
• R26 Very toxic by inhalation
• R37 Irritating to the respiratory system
• R42 May cause sensitisation by inhalation

Other lung diseases caused by work

If your breathing problems are not caused by a sensitiser at work, they may be work-related all the same. Other materials cause chronic obstructive lung disease (including emphysema), or diseases that limit lung capacity, such as asbestosis, silicosis or hard metal disease.

Your employer is obliged to have information on each substance used under the Control of Substances Hazardous to Health Regulations (COSHH). If you are in a union, your safety rep or shop steward, or your national safety officer may have information on the chemicals you work with. Contact SOHAS, who have a database of information on sensitisers and may be able to advise you on how exposure to particular substances can be prevented.

Prevention

By law your employer has to have assessed the risk that could result from their use (COSHH Regulation 6). Employers have to provide you with information about ‘the nature and the degree of risk arising’ from using a substance (COSSH Regulation 12). They should also have information on the hazards of a substance provided by the supplier (Health and Safety at Work Act section 2). This might warn that a substance is a sensitiser.

If there is a risk to health, health checks should be carried out and exposure should be monitored. Employers must decide what precautions are needed to prevent or adequately control exposure. The COSHH Essential pack provides useful solutions to problems of exposure. Each solution takes into account the possible health effects of materials in use, the kind of exposure occurring; dust, fume or gas; and the amount of exposure. This decides what kind of measures are required.

Compensation

Compensation for occupational asthma is available in two ways:

• From the Department of Social Security office (part of the Department for Work and Pensions) on a form for disablement benefit and reduced earnings allowance on form BI 100 OA.
• Through a common law compensation claim from your employer’s insurance, via a solicitor. Making one claim doesn’t stop you making another.

To obtain Disablement Benefit for occupational asthma

• Your asthma must have started or been made worse at work.
• You must have been exposed to a substance known to have this effect (a so-called ‘sensitiser’). See below.
• You must have been exposed to this sensitiser at work in the last 10 years.
• If your asthma started before October 1990 you may also be able to get Reduced Earnings Allowance, which compensated you for loss of wages resulting from your asthma.
• The forms can be off-putting. Ask your union representative or a SOHAS adviser to assist you in filling them in.

What will happen when you make your claim for disablement benefit?

The DSS office will check with your employer at the time your occupational asthma started or was aggravated, that you worked with the substance you say you did. The consequences of this are something you will have to take account of before you claim. Who will negotiate your job security if your employer says that you have to be moved from your job? If the DSS accepts your claim, you will go to a Medical Board (an adjudicating medical authority) which will decide whether your asthma is due to work and how disabled you are by it.

If what you say has caused your asthma is not confirmed then the Medical Boards can get the help of other people – the Health and Safety Executive inspectors and their doctors in the Employment Medical Advisory Service – to find out if they have any evidence that the chemical you mention was present. You can only appeal a Medical Board’s decision on medical grounds. This includes identifying a sensitising substance you have been exposed to.

Claiming damages

Civil claims for compensation (damages) are made through a solicitor. If you are in union, use your union solicitor. Otherwise it is important to get an assessment of the strength of your claim before starting legal proceedings. Even if a ‘no win-no fee’ agreement is available you may have to pay for initial medical investigations.

Make sure that the solicitor you choose is a personal injury solicitor with experience of claims involving occupational diseases. The Association of Personal Injury Lawyers has a list of personal injury solicitors practising in Sheffield. Civil claims are based on proof of negligence by your employer, causation (your lung problem – not necessarily asthma solely caused by work – was caused by work) and liability.

Campaigning on asthma

Occupational asthma puts workers’ jobs and pay at risk. Many workers leave work at higher rates of pay for lower paid jobs because their asthma is becoming progressively worse while at work. Occupational asthma is quite common and often goes undetected because the right questions are not asked when it starts. Each case demonstrates that chemical exposures at work are not controlled and that others are at risk. There are often ways of substituting chemicals that cause asthma with others that do not. Union safety representatives should make sure that workers with occupational asthma are safeguarded while the cause is eliminated.