A guide to the diagnosis and treatment of occupational asthma

Jeffrey T. Rabatin, Clayton T. Cowl

Research output: Contribution to journalReview article

11 Scopus citations

Abstract

Occupational asthma is the most prevalent form of occupational lung disease in industrialized nations. As increasing numbers of new chemicals are produced and new manufacturing processes are introduced, the variety of environments in which individuals may become exposed to respiratory sensitizers and irritants makes diagnosing and treating this illness even more challenging. In addition to adverse pulmonary effects, the diagnosis of occupational asthma may bring with it negative social and financial implications that may ultimately affect the patient's quality of life. For this reason, it is important for clinicians to recognize work-related respiratory symptoms early on in their course, maintain a high clinical suspicion for an occupational cause in the diagnostic work-up of asthma, and have a high degree of certainty in the diagnosis. While a number of classification schemes have been proposed to simplify the diagnostic approach to occupational asthma, the inciting factors typically involve sensitization (often by an IgE mechanism), direct airway inflammation, various pharmacologic responses, or irritant reflex pathways. Clinicians must first document the presence of asthma, then establish a relationship between asthma and the workplace. The occupational history is the key diagnostic tool, and clinical suspicions may be evaluated further by serial peak expiratory flow measurements, nonspecific hypersensitivity challenges with histamine or methacholine, collaboration with industrial/occupational hygienists to obtain workplace exposure measurements, and specific challenge testing at tertiary referral centers providing specialized laboratories. Removal from the inciting exposure is the mainstay of therapy, and pharmacologic treatment of patients with occupational asthma is similar to the treatment of patients with other forms of asthma.

Original languageEnglish (US)
Pages (from-to)633-640
Number of pages8
JournalMayo Clinic proceedings
Volume76
Issue number6
DOIs
StatePublished - 2001

Keywords

  • OSHA = Occupational Safety and Health Administration
  • PEFR = peak expiratory flow rate
  • PEL = permissible exposure limit
  • TLV = threshold limit value

ASJC Scopus subject areas

  • Medicine(all)

Fingerprint Dive into the research topics of 'A guide to the diagnosis and treatment of occupational asthma'. Together they form a unique fingerprint.

  • Cite this