Blocked from return to work w/ controlled asthma?

[Ek55]

Hi,

I know many people are worried about returning to work during the current situation because they are asthmatic, but I seem to have the opposite issue - my work medical unit blocked my return because I'm asthmatic, but my asthma is totally controlled and I take one inhalation of seretide accuhaler each day (100 - the weakest one) and one spray of dymista - i don't even know where the blue inhaler is because i don't need it and I run, cycle, row etc. My workplace is in a country with limited health facilities and I think they rejected me because my workplace hasn't secured any ventilators within that system, but even when I had my only severe asthma exacerbation, it's not like I needed a ventilator, just 3 days of prednisone! Otherwise I am early 30s, no other health issues, not overweight.

My context is that I acquired this asthma in my mid-20s and seemed linked to allergic rhinitis and I developed a random intolerance to ibuprofen which triggers the asthma. It's completely controlled now and I don't notice a thing - I feel like perhaps it is inflammatory. I've been to a couple of decent doctors and have intl private insurance, so no one doctor or 'asthma specialist'. if it ever flares up, then seretide for a while works perfectly.

The reason I disclosed the asthma to my work medical unit for my planned return was because back in January I had a really bad flu for a couple days, and then a cough that got progressively worse to mid February, at which point I was unable to breathe (like 75 instead of 500 on the peak flow monitor), coughing fits that made me nearly collapse, coughing up bloody mucus at one point from the force.. basically this was a severe asthma exacerbation triggered by the flu i think, but i did not know it was asthma because i had never had this kind of thing, so i thought it was a cough or i had pneumonia. In any event, during that incident, I went to the clinic at my job for help, and told them I was asthmatic...they did not examine me or listen to my lungs, and prescribed me cough syrup and 'time' and some random antibiotics, even when i went back and said it was getting worse. In the end i booked my own flight to a neighbouring clinic and went to a competent doctor, who tested me for pneumonia etc. said i seemed to have a huge inflammatory response and put me onto seretide at 250 (now tapered well down), and 3 days of prednisone (never taken before) - all of which worked within 2 days to make me feel WAY BETTER nearly instantly. I took it easy for a week and within a month I was running again etc. I think if I had seen a doctor sooner that was competent I would never have had it so exacerbated, but since the same clinic that prescribed cough syrup is the same one approving my return, I disclosed it when I applied for clearance to return to my job incase they remembered me.

I get that COVID is unpredictable but I feel this is kind of unreasonable. I know there are men over 60 who are overweight going back to work and being approved, including some who wheeze when they speak, but odd that I've been blocked. Wondered if anyone has experienced anything similar? Of course, i don't want to complain because I have a flexible job that is strict it seems on health, but I'm curious.

Many thanks

[nortytorty]

Im 63 and work in primary school ...... we cannot wear face masks and there is no social distancing with young children. The Gov guidance wasinitially people over 60 and anyone with a health condition were classed as clinically vulnerable therefore should social distance and wear as mask or work from home ( however NOT for those working in primary lol). Within 24 hrs the guidance changed and they said over 70s ( my assumption is they realised there is a vast number of people over 60 working and they want them in work to keep the economy going). If your asthma is controlled and you can at least wear PPE according to the guidlines you should be at work. However anyone who can work from home ( ie office based staff ) then the guidelines say you should .

[Poobah]

It very much depends on the guidelines published by the government of the country in which you work. You say your workplace is in a country with limited health care facilities. It's impossible to give any advice from the UK about the health and safety arrangements in other countries.

In the UK your employer would have a legal duty of care for you and would seek specialist advice from an occupational health professional about your specific health risks in the workplace, especially in light of covid. The employer would be legally obliged to make reasonable adjustments to your workplace or duties, as recommended by the OH, as far as they were reasonable. Working from home is a reasonable adjustment and many UK employers have many employees WFH, regardless of their health as it's seen as the safest option in the middle of a pandemic.

I can't speak for other countries, but in the UK it is still the employer's responsibility to look after their employees even if those employees refuse to take precautions for their own good while in the performance of their duties.

Sounds like your employer is taking precautions and if you're able to access occupational health services then that may be a way to reach an agreement on what you can and can't do while this pandemic continues.

[Curlys]

Hi,

I had exactly the same thing happen to me. On Wednesday my headteacher called in the evening to say I was not to come into school. I explained I was controlled! I arranged for a phone consultation with my consultant who recommended I have a blood test, record my peak flows for him. He said if all was well he would write a letter to say I could return back to teaching. I am very much like you, I felt taken back that they made such a decision. (In a nice way!)

I have an OH report and risk assessments in place at school and a protocol when I have a severe attack. I'm currently on Forstair 200/6 twice a day, Spiriva once a day, Montelukast 10mg once a day and Uniphyllin 200mg twice a day and blue inhaler when needed. I use Prednisolone about 5/6 times a year for flare-ups.

If you feel comfortable have a chat with work again. Maybe you can reach an agreement with them?

[EvieJo]

Hi, did you mean another county? Or another country 😀? Do you live outside of the uk?

[EvieJo]

I only ask as I’m in the uk, my workplace (medical) asked about me shielding again etc especially as they know my asthma isn’t under brilliant control at the moment but I’ve already been temp redeployed to a admin role and it’s as safe as it can be - plus I’m only in my early 40’s so I don’t think I have any other risk factors. I’m sure I would be able to work from home but for my overall health I do feel I’m better in the workplace. There is going to be risk for sometime and I need to get used to that, If I got used to working from home - I don’t think I’d ever want to back!! Hope you can work something out - it doesn’t sound like you are particularly high risk from what you’ve said.

[Ek55]

Many thanks for the replies.

I live in the UK at the moment, but my job is another country and yeap it's related to workplace policies but they seem to be somewhat randomly applied, since I know overweight men over 60 who were permitted to return. I believe the main concern is that if anyone is sick, they cannot guarantee a ventilator in that country...but my worst exacerbation basically required seretide/3 days of prednisone, and I never used that in 7 years of asthma, was just a particularly bad flu earlier this year, which, tbh, if timing was different, could have been COVID anyway, and I had the flu vaccination already anyway already. Not that they asked.

If I had severe asthma, I would never have been cleared to work there in the first place, regardless of covid. I guess they are just being overly-cautious, but, again, not sure why they allow the overweight 60 year old men back. It genuinely didn;t occur to me that on this dose of medicine and totally controlled asthma i would be blocked, since otherwise totally healthy/regular runner/cyclist and early 30s/female. I don't feel I can challenge them without appearing like a crazy person at risk of dying of covid who is pushing to get back to work so I will stay out for now but it's really going to impact my life/career negatively in quite a few ways. The job isn't frontline health work or in a school or anything, so with PPE and distancing it would be fine, even when there were a few cases in the workplace, it was quickly isolated, and 99 per cent of staff who have been there did not catch it despite the international travel and the country having a high rate.

Anyway, I was curious to know if anyone else had been blocked from returning to work and the severity of symptoms - so this is helpful.

[Griffon]

Hi , there is no evidence that controlled asthma places a sufferer at greater risk from Corona infection . In fact the evidence suggests that there may be some slight benefit from controlled asthma due to the anti inflammatory drugs taken .