Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Most people with asthma have sudden attacks or periods of bothersome or severe symptoms separated by periods of mild symptoms or no symptoms at all.
Asthma is an inflammatory reaction that is triggered by external factors or specific situations.
When a person with asthma is exposed to one of his or her triggers, the inflammation worsens and symptoms ensue.
Occupational asthma is a breathing (respiratory) disease caused by exposure to a trigger in the workplace. A trigger is an external factor or condition in the body that causes the asthma to occur or worsen. The list of known triggers is long and varied.
The trigger generally is something inhaled.
Occupational asthma can occur in almost any line of work or any work environment, including offices, stores, hospitals, and medical facilities.
Triggers of asthma include contaminants in the air, such as smoke, chemicals, vapors (gases), fumes, dust, or other particles; respiratory infections, such as colds and flu (viruses); allergens in the air, such as molds, animal dander, and pollen; extremes of temperature or humidity; and emotional excitement or stress.
Four types of occupational asthma attacks occur.
Aggravation of preexisting asthma: This is by far the most common type. Over time, with regular exposure, you develop hypersensitivity to the trigger. With this underlying asthma, continued exposure to the trigger causes attacks.
Immunologic asthma is characterized by a delay in the onset of symptoms.
Nonimmunologic asthma seems to occur after single or multiple exposures to irritant material.
Mixed forms can include components of the three other mechanisms described above.
Once the attack is triggered, the airways begin to swell and tighten (bronchospasm) and secrete large amounts of mucus.
The swelling and extra mucus partially block, or obstruct, the airways. This makes it more difficult to push air out of your lungs (exhale).
If this occurs for a period of time, the inflammation can result in abnormal airflow obstruction even when not having an attack. When lung function no longer returns to normal after years of chronic inflammation, asthma evolves into a new class of lung disease referred to as chronic obstructive pulmonary disease (COPD).
Asthma cannot be cured, but it can be controlled by medication.
You have a better chance of controlling your asthma if it is diagnosed early and treatment begun right away.
With proper treatment, you can have fewer and less severe attacks.
Without treatment, you will have more frequent and more severe attacks. You can even die from a severe asthma attack.
Early recognition and avoidance of the asthma trigger is particularly important in occupational asthma.
Because people spend so much time at work, they tend to have extensive exposure to their trigger by the time the cause of the symptoms is recognized as asthma.
The more time you spend exposed to your trigger, the more likely you are to have permanent lung inflammation and airway hypersensitivity.
Occupational asthma is the most common work-related lung disease in developed countries. In up to 15% of people with asthma in the United States, the condition is at least partly related to their work.