Diagnosis and Management of Work-Related Asthma: American College of Chest Physicians Consensus Statement

Details

• Personal Author:
  Balkissoon R ; Balmes J ; Beach J ; Beckett W ; Bernstein D ; Blanc PD ; Brooks, Stuart M. ; Cowl CT ; Daroowalla, Feroza ; Harber P ; Heitzer J ; Lemiere C ; Liss, Gary M. ; Pacheco KA ; Redlich CA ; Rowe B ; Tarlo SM
• Description:
  Background: A previous American College of Chest Physicians Consensus Statement on asthma in the workplace was published in 1995. The current Consensus Statement updates the previous one based on additional research that has been published since then, including findings relevant to preventive measures and work-exacerbated asthma (WEA). Methods: A panel of experts, including allergists, pulmonologists, and occupational medicine physicians, was convened to develop this Consensus Document on the diagnosis and management of work-related asthma (WRA), based in part on a systematic review, that was performed by the University of Alberta/Capital Health Evidence-Based Practice and was supplemented by additional published studies to 2007. Results: The Consensus Document defined WRA to include occupational asthma (ie, asthma induced by sensitizer or irritant work exposures) and WEA (ie, preexisting or concurrent asthma worsened by work factors). The Consensus Document focuses on the diagnosis and management of WRA (including diagnostic tests, and work and compensation issues), as well as preventive measures. WRA should be considered in all individuals with new-onset or worsening asthma, and a careful occupational history should be obtained. Diagnostic tests such as serial peak flow recordings, methacholine challenge tests, immunologic tests, and specific inhalation challenge tests (if available), can increase diagnostic certainty. Since the prognosis is better with early diagnosis and appropriate intervention, effective preventive measures for other workers with exposure should be addressed. Conclusions: The substantial prevalence of WRA supports consideration of the diagnosis in all who present with new-onset or worsening asthma, followed by appropriate investigations and intervention including consideration of other exposed workers. Errata (https://doi.org/10.1016/S0012-3692(08)60336-0): Some of the subheadings in the print version are misleading. The online version has been corrected and should be used. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Diagnosis Lung Diseases Occupational Exposure Occupational Health Respiratory System Respiratory Tract Diseases Safety
• Keywords:
  Author Keywords: Asthma Clinical Diagnosis Diagnostic Tests Disease Prevention Lung Disease Occupational Asthma Occupational Exposure Occupational Lung Preventive Medicine Respiratory Diseases
• ISSN:
  0012-3692
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  134
• Issue:
  3
• NIOSHTIC Number:
  nn:20058504
• Citation:
  Chest 2008 Sep; 134(3)(Suppl):1S-41S
• Contact Point Address:
  Susan M. Tarlo, MBBS, FCCP, Toronto Western Hospital EW7-449, 399 Bathurst St, Toronto, ON, Canada M5T 2S8
• Email:
  susan.tarlo@utoronto.ca
• Federal Fiscal Year:
  2008
• Performing Organization:
  University of California Los Angeles
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Chest
• Supplement:
  Supplement
• End Date:
  20270630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:39979ec3a4e80fc5b1ed8c1186b02a81c9145092acb4b6777d31f812bb02bd12401e71638a9adcfe2bc3eb55a52aa37582c824792579673f8e47303ceaa1e4a4
• Download URL:
  https://stacks.cdc.gov/view/cdc/221585/cdc_221585_DS1.pdf
• File Type:
  [PDF - 4.70 MB ]