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Update on the Management of Occupational Asthma and Work-Exacerbated Asthma
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논문 기본 정보

Type
Academic journal
Author
Ambrose Lau (Toronto Western Hospital and St. Michael's Hospital) Susan M. Tarlo (Toronto Western Hospital and St. Michael's Hospital)
Journal
대한천식알레르기학회(구 대한알레르기학회) Allergy, Asthma & Immunology Research Allergy, Asthma & Immunology Research Vol.11 No.2 KCI Accredited Journals
Published
2019.1
Pages
188 - 200 (13page)

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Update on the Management of Occupational Asthma and Work-Exacerbated Asthma
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Abstract· Keywords

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Work-related asthma is the most common occupational lung disease encountered in clinical practice. In adult asthmatics, work-relatedness can account for 15%–33% of cases, but delays in diagnosis remain common and lead to worse outcomes. Accurate diagnosis of asthma is the first step to managing occupational asthma, which can be sensitizer-induced or irritant-induced asthma. While latency has traditionally been recognized as a hallmark of sensitizer-induced asthma and rapid-onset a defining feature of irritant-induced asthma (as in Reactive Airway Dysfunction Syndrome), there is epidemiological evidence for irritant-induced asthma with latency from chronic moderate exposure. Diagnostic testing while the patient is still in the workplace significantly improves sensitivity. While specific inhalational challenges remain the gold-standard for the diagnosis of occupational asthma, they are not available outside of specialized centers. Commonly available tests including bronchoprovocation challenges and peak flow monitoring are important tools for practicing clinicians. Management of sensitizer-induced occupational asthma is notable for the central importance of removal from the causative agent: ideally, removal of the culprit agent; but if not feasible, this may require changes in the work process or ultimately, removal of the worker from the workplace. While workers' compensation programs may reduce income loss, these are not universal and there can be significant socio-economic impact from work-related asthma. Primary prevention remains the preferred method of reducing the burden of occupational asthma, which may include modification to work processes, better worker education and substitution of sensitizing agents from the workplace with safer compounds.
#Asthma #asthma #occupational #case management

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References (74)

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Tarlo SM / 2014 / Occupational asthma / N Engl J Med 370:640~649 google schola Paris C / 2012 / Work-related asthma in France : recent trends for the period 2001–2009 / Occup Environ Med 69:391~397 google schola Ribeiro M / 2014 / Diisocyanate and non-diisocyanate sensitizer-induced occupational asthma frequency during 2003 to 2007 in Ontario, Canada / J Occup Environ Med 56:1001~1007 google schola Walters GI / 2015 / Twenty years of SHIELD : decreasing incidence of occupational asthma in the West Midlands, UK / Occup Environ Med 72:304~310 google schola Suojalehto H / 2018 / 3-(Bromomethyl)-2-chloro-4-(methylsulfonyl)-benzoic acid : a new cause of sensitiser induced occupational asthma, rhinitis and urticaria / Occup Environ Med 75:277~282 google schola

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