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Medical Author:

George Schiffman, MD, FCCP

George Schiffman, MD, FCCP

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.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

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.

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The most important part of treating occupational asthma is avoiding the trigger.

• Most people assume that means quitting their job and changing their occupation, but this is not always the case.



• Many employers will work with you to reduce or stop your exposure. This may mean changing the way things are done in the workplace overall or it may mean providing extra protection for you. It may mean moving you to a different location in the workplace.



• Because acceptable solutions often can be found, many asthma specialists recommend not quitting your job until all possibilities have been exhausted. If your asthma is very severe or cannot be controlled in the workplace, however, you may have to leave your job right away.

Once the diagnosis of asthma has been confirmed, you may be started on a regimen of medications. Asthma medications are of the following two types:

• Controller medications: These are for long-term control of persistent asthma. They help to keep airways open and reduce the inflammation in the lungs that underlies asthma attacks. You take these every day whether you are having symptoms or not.



• Rescue medications: These are for short-term control of asthma attacks. You take these only when you are having symptoms or are more likely to have an attack; for example, when you have an infection in your respiratory tract.

Your treatment plan will also include the following:

• Awareness of your trigger and avoiding the trigger as much as possible



• Recommendations for coping with asthma in your daily life



• Regular follow-up visits to your health-care provider to monitor your condition, whether you are on medication or not

Together, you and your health-care practitioner will develop an action plan for you in case of asthma attack. The action plan will include the following:

• How to use rescue medication



• What to do if the rescue medication does not work right away



• When to call the health-care provider



• When to go directly to a hospital emergency department

Your health-care practitioner may want you to use a peak flow meter regularly, at least at first, to monitor how being at work affects your airway. The peak flow meter is a simple, inexpensive device that measures how forcefully you are able to exhale.

• This is a good way to help you and your health-care provider assess the severity of your asthma.



• Ask your health-care practitioner or an assistant to show you how to use the peak flow meter. He or she should watch you use it until you can do it correctly.



• Keep a record of the results. Over time, your health-care practitioner may be able to use this record to improve your medications, reducing dose or side effects.



• Peak flow measures fall just before an asthma attack. If you use your peak flow meter regularly, you may be able to predict when you are going to have an attack.



• It can also be used to check your response to rescue medications.

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