Diagnostic approach in cases with suspected work-related asthma

Details

• Personal Author:
  Aasen TB ; Baur X ; Burge PS ; Henneberger, Paul K. ; Schlunsses V
• Description:
  Background: Work-related asthma (WRA) is a major cause of respiratory disease in modern societies. The diagnosis and consequently an opportunity for prevention are often missed in practice. Methods: Based on recent studies and systematic reviews of the literature methods for detection of WRA and identification of specific causes of allergic WRA are discussed. Results and Conclusions: All workers should be asked whether symptoms improve on days away from work or on holidays. Positive answers should lead to further investigation. Spirometry and non-specific bronchial responsiveness should be measured, but carefully performed and validly analysed serial peak expiratory flow or forced expiratory volume in one second (FEV1) measurements are more specific and confirm occupational asthma in about 82% of those still exposed to the causative agent. Skin prick testing or specific immunoglobulin E assays are useful to document allergy to high molecular weight allergens. Specific inhalational challenge tests come closest to a gold standard test, but lack standardisation, availability and sensitivity. Supervised workplace challenges can be used when specific challenges are unavailable or the results non-diagnostic, but methodology lacks standardisation. Finally, if the diagnosis remains unclear a follow-up with serial measurements of FEV1 and non-specific bronchial hyperresponsiveness should detect those likely to develop permanent impairment from their occupational exposures. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Lung Lung Diseases Occupational Health Preventive Medicine Respiratory Function Tests Respiratory System Respiratory Tract Diseases Safety Workplace

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• Keywords:
  Analytical-processes Bronchial-asthma Health-care Health-protection Molecular-biology Preventive-medicine Pulmonary-disorders Pulmonary-function Pulmonary-system Pulmonary-system-disorders Respiration Respiratory-system-disorders Spirometry Work-environment Workers

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• ISSN:
  1745-6673
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  17
• Volume:
  8
• NIOSHTIC Number:
  nn:20043014
• Citation:
  J Occup Med Toxicol 2013 Jun; 8:17
• Contact Point Address:
  Tor B Aasen, 1Department of Occupational Medicine, Haukeland University Hospital, NO-5021 Bergen, Norway
• Email:
  tor.aasen@helse-bergen.no
• Federal Fiscal Year:
  2013
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Occupational Medicine and Toxicology
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b7f99450e634a7768477ef0b9d37d8b1b6647802a6788945e5c05c79e24e0b992afa5c7fe5fd54278ca3b21c55b27ced47545ee7811dc594d573881bcf209166
• Download URL:
  https://stacks.cdc.gov/view/cdc/195048/cdc_195048_DS1.pdf
• File Type:
  [PDF - 263.58 KB ]