1. Strategic Plan for Addressing Work-Related Asthma in Minnesota Minnesota Department of Health (MDH) October 2006

2. 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

3. Triggers and Irritants Things that may initiate an asthma attack

4. 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

5. 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

6. 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

7. 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 self- management and minimize exposures in the work environment. WRA Strategic Plan

8. 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

9. 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 The Process

10. 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

11. 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

12. 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 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 www.health.state.mn.us/divs/hpcd/cdee/asthma/StatePlan.html

13. Contact Information Laura Oatman Laura.oatman@health.state.mn.us 651-201-5914 MDH Asthma Program www.health.state.mn.us/asthma 651-201-5909 Toll Free: 1-877-925-4189