Definition and diagnosis of occupational asthma

  • André Cartier
Part of the Progress in Inflammation Research book series (PIR)


Occupational asthma is a disease characterized by variable airflow limitation and/or hyperresponsiveness and/or inflammation due to causes and conditions attributable to a particular occupational environment and not to stimuli encountered outside the workplace. Two types of occupational asthma are distinguished based on their appearance after a latency period or not: the classical occupational asthma requiring a period of sensitization and irritant-induced asthma occurring after acute exposure to high concentrations of irritants. The diagnosis of occupational asthma should be based on objective means and cannot rely only on history (which is, although very sensitive, not sufficiently specific) or even on confirming the presence of asthma with positive skin tests to the relevant allergen/agent found at work. Inquiring about direct or indirect exposure to known sensitizers should be part of the questionnaire of any adult with new onset asthma. Monitoring of peak expiratory flows at and off work is a useful tool but may not be sufficiently sensitive or specific; combining it with monitoring of the provocative concentration of methacoline inducing a 20% fall in FEV1 and possibly sputum induction may improve the accuracy of the diagnosis. Specific inhalation challenges in the laboratory or in the workplace are the reference standard for confirming the diagnosis of occupational asthma. They are safe when done under the close supervision of an expert physician by trained personnel. Any new case of occupational asthma should be considered as a sentinel event.


Allergy Clin Immunol Peak Expiratory Flow Occupational Asthma Sputum Induction Sputum Eosinophil 


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Copyright information

© Birkhäuser / Springer Basel 2010

Authors and Affiliations

  • André Cartier
    • 1
  1. 1.University of Montreal, Department of MedicineHôpital du Sacré-Coeur de MontréalMontréalCanada

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