Shellfish OHS

Shellfish Processing Industry in Eastern Canada

Shellfish species Processed in Eastern Canada

A Second Wind: Questions and Answers

1. What is Crab Asthma?
2. What causes Crab Asthma?
3. What are the symptoms of Crab Asthma?
4. How can crab workers find out whether or not they have Crab Asthma?
5. A Second Wind suggests that women are more susceptible to Crab Asthma than men. Why?
6. Does smoking increase the risk of developing Crab Asthma?
7. The plant manager would like to know who is likely to get Crab Asthma. Is it possible to screen workers when they are being hired to weed out those most at risk of developing this problem?
8. Would increased ventilation in the plant help prevent Crab Asthma?
9. Why isn’t everyone required to wear a mask? Wouldn’t they want to wear a mask of some sort? And why would the employees be responsible for the cost of the masks?
10. Are workers not required to wear gloves?
11. What will happen to Linda if she keeps working at the plant?
12. If Linda was moved to making boxes would she stop having symptoms?
13. Linda’s daughter says the puffer is only ‘buying her mother time’. What does she mean by that?
14. Tell me more about the two different kinds of puffers.
15. Don’t crab plant workers have drug plans to pay for their prescription drugs?
16. Why doesn’t the plant manager admit there is a problem?
17. Do people fear they will lose their jobs if they bring up the issue of Crab Asthma?
18. Why did ‘Linda’ not want to admit she had Crab Asthma?
19. Why would Linda want to expose her daughter to potential harm?
20. Where can I get more information on Crab Asthma?

1. What is Crab Asthma?
It is a form of occupational asthma that affects some crab processing workers. Asthma is a condition that results in breathing difficulties. These breathing difficulties occur when the breathing tubes tighten up and become swollen. It is considered to be occupational, or work-related, when it is caused by exposures at work.

2. What causes Crab Asthma?
It is caused by exposure to crab proteins found in dust, steam, and vapor. Crab proteins get in the air during such activities as cleaning, steaming, boiling, washing, sawing, or crushing crab in processing plants. These crab proteins are breathed in. Over time, some workers become sensitized to these proteins and develop an allergy to snow crab. This allergy can result in occupational asthma and, in some cases, other allergic symptoms such as skin problems (dermatitis).

3. What are the symptoms of Crab Asthma?
Symptoms of Crab Asthma are chest tightness, wheezing, coughing and difficulty breathing. These symptoms are generally worse at work and better away from work but may also happen in the evening.

4. How can crab workers find out whether or not they have Crab Asthma?
If a worker thinks they have Crab Asthma, they should start by visiting their family doctor, who might refer them to a lung specialist. A work and medical history questionnaire, skin test or blood test to show allergy to crab, and a lung function test (both at work and not at work) can be used to test for Crab Asthma. It is important to remain at work while this type of testing is being carried out. Workers who have had severe asthmatic attacks may be withdrawn from the workplace prior to the end of the tests. The doctor may also ask workers to keep a record of the time of day that symptoms occur, the effects on the body, any periods of improvement or worsening and the overall pattern of the symptoms. Workers with Crab Asthma can respond immediately to the crab proteins or they might respond later in the day or in the evening, away from work.

5. A Second Wind suggests that women are more likely to develop Crab Asthma than men. Why?
In many workplaces, men and women tend to do different jobs. As a result, they may have different workplace exposures and therefore develop different kinds of injuries and illnesses at work. Research done in Newfoundland and Labrador snow crab processing plants found women were more likely than men to test positive for allergy and asthma to snow crab. In these plants, on average, women had worked longer than men with crab and they were more likely to have worked at jobs with higher allergen exposures. As a result, on average, the cumulative exposures of women workers in this study were higher than those of the men workers. Since the likelihood of developing crab asthma increases with the level of exposure, this difference helped to explain the larger number of positive tests among women workers. In this study, men were more likely than women to work outside the main processing area and, in some cases, on the wharf.

6. Does smoking increase the risk of developing Crab Asthma?
Smoking is bad for your health and should be avoided. Smokers appear to be at higher risk of developing Crab Asthma but smoking does not cause Crab Asthma.

7. The plant manager would like to know who is likely to get Crab Asthma. Is it possible to screen workers when they are being hired to weed out those most at risk of developing this problem?
People who smoke and those who are atopic (i.e. who have a genetically determined hypersensitivity to allergens) appear to be more likely to develop Crab Asthma. However, almost 50% of the general population is atopic and many people smoke. In addition, some people who develop Crab Asthma are not atopic and do not smoke. Screening would not be the most appropriate or the most effective way to reduce the risk of Crab Asthma.

8. Would increased ventilation in the plant help prevent Crab Asthma?
Organizing work and designing machinery in ways that reduce the amount of protein that gets into the air can help reduce the risk. In addition, plants should include a well designed ventilation system. Well designed systems remove the proteins at the point where they first get into the air. They do this by drawing the air with the proteins away from the breathing zones of the workers. This air is vented directly outside. Ventilation systems need to be designed so that make-up air can be brought into the plant to replace the air that is being removed. The exhaust vent needs to be located in a way that prevents bad air from getting drawn back into the plant through the air intake or an open door or window. A ventilation system that just blows air around (or one that is poorly designed), might actually increase the number of workers at risk.

9. Why isn’t everyone required to wear a mask? Wouldn’t they want to wear a mask of some sort? And why would the employees be responsible for the cost of the masks?
Personal Protective Equipment like masks should be a last resort in a prevention plan – coming after steps to stop the proteins from getting in the air and the installation of an effective and appropriate ventilation system. When masks are used, they should be appropriate for the types of exposures and individual workers need to be fit-tested to make sure they don’t leak around the edges. As well, masks are often uncomfortable to wear in a damp environment like that found in crab plants – which may affect workers’ willingness to wear them. In Newfoundland and Labrador plants, workers wearing masks have reported that employers expected them to pay for them. To our knowledge, the masks they have been wearing have generally not been fit-tested or evaluated to ensure that they are effectively filtering out the proteins.

10. Are workers not required to wear gloves?
Most crab processing workers wear gloves. This may reduce the risk of skin problems.

11. What will happen to Linda if she keeps working at the plant?
Some, but not all workers with Crab Asthma who continue to work with crab find that their asthma gets worse. In the short term, they often find they are fine when they are away from work on the weekend or in the off season. The longer workers continue to work with crab after they develop Crab Asthma, the greater the risk that they will continue to have breathing problems after they leave their jobs. These problems may be triggered by such things as exercise, perfumes, cigarette smoke and cold weather.

12. If Linda was moved to making boxes would she stop having symptoms?
Boxes are often assembled in an area away from the main crab processing work so the amount of protein in the air should be lower here. Other places where she might have fewer symptoms could include working on the wharf (if the fumes from the plant are vented away from this area) or perhaps work in the office or cold storage. If she is very allergic it might be hard for her to work anywhere around crab. Some workers who report severe symptoms say these can be triggered even by allergens on the clothes of family members when they come home from the plant.

13. Linda’s daughter says the puffer is only ‘buying her mother time’. What does she mean by that?
The medication can help Linda manage her asthma and relieve her acute symptoms. However, it cannot cure it or eliminate the risk that it will get worse if she continues to work with crab.

14. Tell me more about the two different kinds of puffers.
“Puffers” or inhalers are essential to those who are prone to asthma attacks. Most people with asthma will be prescribed two kinds of medicine, rescue medicine and controller medicine. Rescue medicine comes in the form of an inhaler often blue in color. It is kept on hand to be taken during an asthma attack, if breathing gets bad, or sometimes before exercise. However, it only helps in the short term. Controller medicine can come in the form of an inhaler (of various colors: orange, brown, burgundy, purple, red) or pill. It is taken everyday to ensure airways stay clear and to reduce swelling in the breathing tubes. It is used to control symptoms (not to acutely relieve them) and reduce the need for the reliever inhaler. It contains corticosteroids (not the steroids that enhance muscle strength). These steroids are an anti-inflammatory medication that decreases airway swelling in the lungs.

15. Don’t crab plant workers have drug plans to pay for their prescription drugs?
In Newfoundland and Labrador, crab plant workers, like many other seasonal workers, do not have drug plans. They have to pay for their own medications. The exception would be medications required to treat work-related illnesses for which they have filed a successful claim with their provincial workers’ compensation commission.

16. Why doesn’t the plant manager admit there is a problem?
The plant manager is in a difficult position. He doesn’t seem to know a lot about the problem or how to fix it – something that needs to change. His company is legally obligated to provide an environment that is safe and without risk to the health of its employees. He knows his workers and their families and feels he is doing what he can to help out. He could be working more effectively with the plant’s health and safety committee, local doctors and OHS experts to reduce the risk of Crab Asthma.

17. Do people fear they will lose their jobs if they bring up the issue of Crab Asthma?
Crab processing workers tend to be seasonal workers; they are often not unionized and frequently live in remote, single industry communities. If they lose their job in the plant or don’t get enough hours of work during the season, they may have to move away to find work. This means they are vulnerable workers. There are a limited number of positions in these plants where a worker would not be exposed to crab allergens. If there is no work available in those areas of the plant, or if there is less work in those areas, workers may not get enough hours to qualify for Employment Insurance (E.I.). This is an issue, as this type of work is seasonal and workers depend on E.I. for income during the off-season. Workers who fail to qualify for E.I. in a particular season may have to work more hours in order to qualify the following year. Also, time off work on Compensation cannot easily be counted towards E.I. eligibility. All of these issues make it hard for workers to bring up the issue of Crab Asthma with their employers.

18. Why did ‘Linda’ not want to admit she had Crab Asthma?
Linda doesn’t know that she has Crab Asthma and no doubt hopes that she doesn’t have it. It is hard to understand something like Crab Asthma if you don’t have access to well-trained health professionals and a clear diagnosis. It is important for Linda to get a clear diagnosis before she decides she has Crab Asthma because it is possible that Linda’s asthma is being caused by something else in her life and not by crab. When she gets a clear diagnosis, Linda will have to decide what she is going to do with that information. Given her choices, it is not surprising that she might be nervous about admitting she might have Crab Asthma.

19. Why would Linda want to expose her daughter to potential harm?
In Newfoundland and Labrador, in recent years most plant workers appear to be discouraging their children from taking jobs in fish and shellfish plants. Some reasons for this could be that the work has become so uncertain, the wages are often fairly low, and because of the risk. This suggests that Linda is not typical of plant workers today, but would have been more typical of plant workers in the past. That said it is normal for parents to want to have their children living near them. The fishing industry will need young workers in the future if it and our rural communities are going to survive. A renewed fishing industry needs to be a safe industry where our youth and current workers don’t feel they have to “choose between their jobs and their health”.

20. Where can I get more information on Crab Asthma?
You can contact your family doctor and your provincial workers' compensation commission. Some information is also available at www.shellfishohs.ca.

General Crab Asthma FAQ's (PDF)

References

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