July 15, 2008

 

 Occupational asthma a risk for veterinarians - July 15, 2008

 

Take proactive measures to increase safety

 
posted July 1, 2008
 

Veterinarians are bombarded daily with animal proteins, powder proteins from latex gloves, powdered medications, and various other substances that, with long-term exposure, can put them at risk for occupational asthma.

In fact, the American Academy of Allergy, Asthma and Immunology identifies veterinarians as one of the professions at highest risk for occupational asthma, which results from long-term exposure to a substance that causes the body's immune system to develop antibodies or other immune responses.

It can take months and even years of exposure before symptoms of asthma develop; the most common are wheezing, shortness of breath, chest tightness, difficulty exercising, and coughing. However, early diagnosis of occupational asthma is critical. Unless action is taken to reduce or eliminate exposure, permanent lung changes may occur that can lead to symptoms of asthma, even when the person is away from trigger substances.

Asthma can also be deadly. According to the Allergy and Asthma Foundation of America, more than 4,000 people die of asthma each year, and it is a contributing factor in another 7,000 deaths.

Risk factors for occupational asthma include smoking and a previous personal or family history of allergies. However, even those with no such history are vulnerable.

That was the case for Dr. Dan Loper, who had been practicing for three years when his physician began to suspect that the veterinarian was suffering from something more than susceptibility to sinusitis and bronchitis.

Repeated courses of antimicrobials brought relief, but the symptoms always returned and eventually progressed to asthmatic responses. Constant bouts of itchy red eyes, hoarseness, and inflammation of the trachea and the sinus cavities finally led to tests that revealed an allergy to pet dander.

"I had a positive reaction to all the animals they tested me for, and they were all the ones I handled in practice," said Dr. Loper, who had not experienced any clinical symptoms of allergies prior to starting with a small animal practice in Atlanta.

He started allergy desensitization treatments but by that time, he said, he had taken a dramatic turn for the worse and started having chest tightening. "They pushed (treatment) as high as I could tolerate, but it's harder to desensitize the body to animals," he said.

Resistant to all but the most powerful antimicrobials, Dr. Loper risked suffering an asthma attack from which he would not recover each day he went to work. Further, the antimicrobials had destroyed the good bacteria in his intestinal tract, causing chronic diarrhea and painful intestinal inflammation. He was also facing the first in a series of sinus surgeries to repair the damage caused by chronic infections.

Yet it was not until his boss pointed out the likelihood that he might die if he kept practicing that Dr. Loper accepted reality—the veterinary career he loved was over after just five years.

Since leaving the practice, Dr. Loper said his allergic reactions have become less severe, although he still cannot be in the proximity of animals. He has also developed allergies to wheat, dairy products, and eggs.

"Ten years out, my lifestyle is still impacted by what I did in terms of being a veterinarian," said Dr. Loper, who is now a pharmacist.

He is not alone in his struggles with occupational asthma. AAAAI reports that 15 percent of asthma cases in the United States may have job-related factors, and occupational asthma accounts for an estimated 24.5 million missed workdays each year.

In 2007, the AVMA Group Health & Life Insurance Trust paid allergy-related claims in excess of $272,000 and asthma-related claims of more than $250,000.

Because sufferers are frequently misdiagnosed with bronchitis, AAAAI recommends that anyone with a history or symptoms suggesting occupational asthma consult with an allergist/immunologist. Testing can confirm the diagnosis, determine whether it is workplace-related, and guide treatment decisions.

In some cases, reducing exposure and taking medications to counteract symptoms of asthma can help. In others, eliminating exposure is the only option.

The AVMA GHLIT offers disability insurance plans that can help veterinarians meet financial obligations if they become unable to work as a result of occupational asthma or other disabling accidents or illnesses—coverage Dr. Loper highly recommends.

"It's been tremendous for me," he said. "If we had not had the (disability) insurance policy in place, we would have filed for bankruptcy. But we were fortunate. We had good coverage."

The Trust's insurance program is underwritten by New York Life Insurance Company. For more information or to find a GHLIT agent in a particular area, call the Trust office at (800) 621-6360.

To hear Dr. Loper's story and those of other veterinarians, visit www.avmaghlit.org to view the video, "It is Real Life."