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Allergy Frontiers: Diagnosis and Health Economics pp 257–273Cite as

Occupational Asthma

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Part of the book series: Allergy Frontiers ((ALLERGY,volume 4))

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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Author information

Authors and Affiliations

  1. Fundacion Jiménez Diaz, Servicio de Alergia, Av. Reyes Catolicos 2, Madrid, 28040, Spain

    Joaquin Sastre

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  1. Joaquin Sastre
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Editors and Affiliations

  1. Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan

    Ruby Pawankar

  2. Southampton General Hospital, University of Southampton, Tremona Road, Southampton, UK

    Stephen T. Holgate

  3. UMKC School of Medicine, Children's Mercy Hospitals and Clinics, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Lanny J. Rosenwasser

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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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  • DOI: https://doi.org/10.1007/978-4-431-98349-1_15

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-98293-7

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