Occupational asthma (OA) is the most common occupational lung disease in industrialized countries. It is suspected that 9 to 15% of all cases of adult-onset asthma are caused by work factors. OA is a phenotype of the asthma in the workplace that also includes irritant-induced asthma, work-aggravated asthma and variants forms such as occupational eosinophilic bronchitis. More than 350 agents have been implicated in the development of OA. The airway inflammation process is similar in IgE-dependent and IgE-independent OA and is characterized by the presence of eosinophils, lymphocytes, mast cells, and thickening of the reticular basement membrane. Diagnosis of OA should be confirmed by objective testing for asthma and then by establishing the relation between asthma and work that include monitoring of PEF, PC20 and sputum eosinophils at and off work, or specific inhalation challenges. These are still considered the gold standard to confirm the diagnosis of occupational asthma in many cases. Inventory and identification of substances that may be present in the working environment is necessary.
The appropriate treatment remains early removal from exposure to ensure that the worker has no further exposure to the causal agent with preservation of income. However, various studies demonstrate that many workers with occupational asthma continue to remain exposed to the causative agent or suffer prolonged work disruption, discrimination and face unemployment. However, despite removal from exposure, occupational asthma frequently turns into a chronic condition, and requires intensive medical management, including appropriate pharmacotherapy and patient education and counselling. Occupational asthma is the only type of asthma that is readily preventable.
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Sastre, J. (2009). Occupational Asthma. In: Pawankar, R., Holgate, S.T., Rosenwasser, L.J. (eds) Allergy Frontiers: Diagnosis and Health Economics. Allergy Frontiers, vol 4. Springer, Tokyo. https://doi.org/10.1007/978-4-431-98349-1_15
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