Occupational Issues Related to Respiratory Irritants

Abstract

Numerous substances in the workplace can cause irritation of the mucus membranes and respiratory tract. Both physical characteristics and chemical composition of the irritant may influence the effects seen on the airways. Particle size determines the location of deposition in the airways. Water solubility, pH, electric charge, hygroscopicity, and propensity to bind with tissue proteins influence the uptake, deposition, and degree of damage from inhaled respiratory irritants. Health effects of inhaled irritants include rhinitis, vocal cord dysfunction, asthma, emphysema, chronic bronchitis, and reactive airways dysfunction syndrome. In addition inhaled irritants can cause annoyance reactions, irritation, and corrosive changes and even increase the risk of infection. In evaluating complaints from irritant exposure both the worker and worksite should be evaluated. Worker evaluation should include a thorough medical and occupational history, a physical exam focusing on the skin and upper and lower respiratory tract, and appropriate laboratory test which may include pulse oximetry, complete blood count, spirometry, and allergy skin testing. Radiographic scans of the affected organ may give an indication of localized or widespread involvement of that organ. Peak flow monitoring may be useful to determine where exposure may be occurring.