Asthma at work

摘要

1 To minimise the risk of developing occupational asthma, exposure to asthmagens should be prevented and, where this is not possible, reduced to as low as reasonably practicable (ALARP), considering the cost against benefit of removing the residual risk. If exposure is not prevented the remaining risk needs to be effectively managed 2 The journey to preventing exposure starts with thoroughly assessing the activities where asthmagens are present, and then devising a control strategy following the hierarchy of control and employing good occupational hygiene practices. Effective control strategies are usually a suite of controls including administrative controls, engineering controls and personal protective equipment 3 Once the exposure controls have been commissioned and implemented, there should be an ongoing programme that ensures that they are being used as intended, are effective, and that the risk is regularly re-assessed 4 As part of assessing the risk and demonstrating adequate control, exposure assessment will be necessary. Many techniques exist and include air monitoring, biological monitoring and other qualitative and visual techniques. The method used needs to be proportionate to any residual risk posed 5 For exposure controls to be effective and sustainable, they need to be regularly inspected and maintained. Neglecting this will mean that, over time, control effectiveness will decline and the risks of exposure and workers developing asthma will increase 6 Worker engagement with all health-related work issues and the prevention of exposure to asthmagens (and all hazardous materials) is vital to minimise the risk of developing occupational asthma. In addition, all stakeholders should have appropriate training and competence to carry out their role, and those exposed to asthmagens at work should be supervised to ensure that control measures are being used 7 Any training should include background information of the risks associated with working with asthmagens 8 Regular health surveillance of workers is important as it can provide an early indication that illness is occurring; however, it is a lagging indicator (ie the illness has already occurred) and should not be used as the only method for demonstrating control effectiveness