Occupational asthma - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Occupational asthma should be suspected in all adult patients with asthma.
An occupational history should be taken to identify work-related causes. Details of work exposures should be obtained from material safety data sheets and other material available to the patient from their workplace.
Objective evidence of asthma should be obtained from spirometry, a bronchodilator response, and/or a methacholine challenge. Tests should be performed when the patient is symptomatic and/or within days of having exposure to a suspected etiologic agent.
If sensitizer-induced occupational asthma is suspected, additional testing of asthma should be done, preferably while the patient is still working. Whenever possible an immunologic response to a suspected work sensitizer should be demonstrated by skin or in vitro tests.
In sensitizer-induced occupational asthma, removal from any further exposure to that agent should be recommended.

Skin prick test results with natural rubber latex in a nurse with occupational asthma

From Tarlo SM, Wong L, Roos J, et al. Occupational asthma caused by latex in a surgical glove manufacturing plant. J Allergy Clin Immunol. 1990:85:626-631. Used with permission

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Images

Skin prick test results with natural rubber latex in a nurse with occupational asthma
Peak expiratory flow rate (PEFR) and results of methacholine challenge in a patient with occupational asthma

Citations

Key Articles

Tarlo SM, Balmes J, Balkissoon R, et al. Diagnosis and management of work-related asthma: American College Of Chest Physicians Consensus Statement. Chest. 2008 Sep;134(3 suppl):1S-41S.[Abstract]
American College of Radiology. ACR Appropriateness Criteria: occupational lung diseases. 2019 [internet publication].[Full Text]
British Thoracic Society. BTS clinical statement: occupational asthma. Mar 2022 [internet publication].[Full Text]
Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. Jul 2023 [internet publication].[Full Text]
Baur X, Sigsgaard T, Aasen TB, et al. Guidelines for the management of work-related asthma. Eur Respir J. 2012 Mar;39(3):529-45.[Abstract][Full Text]

Other Online Resources

Haz-Map: information on hazardous agents and occupational diseases
Lung Health Foundation: Work Related Asthma
CDC: work-related asthma

Referenced Articles

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