Strategic Plan for Addressing
Work-Related Asthma in
Minnesota
Minnesota Department of Health (MDH)
October 2006
What is Asthma?
Asthma is a chronic disease that causes:
 Tightening of the muscles surrounding the
airways (broncho constriction/spasm)
 Swelling of the small airways (bronchioles)
 Over production of sticky mucus in the
airways
Triggers and Irritants
Things that may initiate an asthma attack
Definitions of WRA
(Centers for Disease Control and Prevention, 1999)
 ‘New-onset asthma’ from workplace exposure to
sensitizers and/or irritants
Occupational asthma (OA)
Sensitizer-induced and irritant-induced asthma over a period of
time not meeting the Reactive Airways Dysfunction Syndrome
(RADS) criterion
Reactive airways dysfunction syndrome (RADS)
Persistent asthma symptoms induced by a one-time, high-level
irritant exposure at work
 ‘Work-aggravated asthma’
Pre-existent asthma worsened by workplace exposures
What we know about WRA
 ~ 15% of adult asthma attributable to
occupational factors (American Thoracic
Society, 2003)
 ~ $1.6 billion in direct & indirect costs
annually (Leigh JP, Romano PS et al., 2002)
 ~ 350 agents associated with WRA*
*Courtesy of Margaret Filios, SM, RN, Division of Respiratory Disease
Studies, NIOSH
WRA in Minnesota
 In 2005, 11.8% of Minnesota adults (444,049
people) have ever been told by a doctor they
have asthma (Centers for Disease Control and
Prevention, 2005)
15% is approximately 66, 600 adults in Minnesota
with asthma attributable to occupational factors
 Existing Minnesota Department of Health Plan:
“A Strategic Plan For Addressing Asthma in
Minnesota” (2002)
Work-Related Asthma was identified as a gap in this
plan by the Centers for Disease Control and
Prevention
WRA Strategic Plan
Work-Related Asthma Advisory Workgroup
Charge: The Work-Related Asthma Advisory
Workgroup is charged with assessing the issues,
determining the priorities, and making
recommendations to deal with work-related asthma
(WRA) including strategies to support asthma selfmanagement and minimize exposures in the work
environment.
WRA Advisory Workgroup
David Abrams, CIH
Beth Baker, MD, MPH
Lisa Brosseau, ScD, CIH
Wendy Brunner, MS
Dana Dickson, MIS, CIH,
CSP
Barbara Gibson, MD,
MPH
Susan Graca, RN, BSN
Ian Greaves, MD
Clayton Handt, MIS
Jean Johnson, MS, PhD
Richard Johnston,
Minnesota Finishing
Trades
Steve Kirkhorn, MD,
MPH, FACOEM
James Kubisiak, MS,
CIH
William Lohman, MD
Dave Mlakar,
Steelworkers Union
Elizabeth Shogren, RN
Allan Williams, MPH,
PhD
The Process
 Followed the process of the original state asthma
plan “A Strategic Plan For Addressing Asthma in
Minnesota”
 Recruited Advisory Workgroup participants
 Scheduled five meetings
 Reviewed the status of WRA at the state and national
levels
 Identified current gaps, barriers and challenges
 Identified solutions – goals, objectives, strategies
Results
 Overarching goals – 3
Increase awareness about WRA and about
identifying and documenting WRA
Improve information on WRA in Minnesota to tailor
interventions
Reduce exposures to asthmagens
 Objectives - 11
 Strategies – numerous
 List of potential partners
Next Steps
1. Identify individuals affiliated with the potential
supporting organizations to become WRA Strategic
Plan partners
2. Identify specific goals, objectives and/or strategies
that partners will commit to implementing and
monitoring
3. Partners will write a letter of support for this plan
including their commitment to implement the
selected goals, objectives and strategies from step
2
4. Implement selected goals, objectives, and
strategies from step 2
Resources
 American Thoracic Society (2003). Occupational Contribution to
the Burden of Airway Disease. Am J Respir Crit Care Med
Vol.167 pp 787-797
 American Thoracic Society (2004). Guidelines for Assessing
and Managing Asthma Risk at Work, School and Recreation.
Am J Respir Crit Care Med Vol. 169 pp 873-881
 Centers for Disease Control and Prevention (1999). CDC
Surveillance Summaries. MMWR 1999;48(No. SS-3)
 Centers for Disease Control and Prevention (2005). Behavioral
Risk Factor Surveillance System Survey Data. Retrieved from
www.cdc.gov/brfss
 Leigh JP, Romano PS et al. (2002). Costs of Occupational
COPD and Asthma. Chest 121:264-272
 Minnesota Department of Health (2002). A Strategic Plan for
Addressing Asthma in Minnesota. Retrieved from
www.health.state.mn.us/divs/hpcd/cdee/asthma/StatePlan.html
Contact Information
 Laura Oatman
[email protected]
651-201-5914
 MDH Asthma Program
www.health.state.mn.us/asthma
651-201-5909
Toll Free: 1-877-925-4189