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American Journal of Respiratory and Critical Care Medicine Vol 173. pp. 357, (2006)
© 2006 American Thoracic Society

Correspondence

Nonspecific Triggers Also Provoke Occupational Asthma

To The Editor:

We would like to make a comment regarding the management of occupational asthma as discussed in the useful State of the Art article on this topic by Mapp and colleagues (1). Based on our clinical experience in a busy urban occupational medicine clinic, patients with occupational asthma—not just those with work-aggravated asthma—continue to progressively react to nonspecific airborne environmental triggers that differ from their original exposure(s), especially in cases when recognition of disease is made late in the course of their disease. Studies in the medical literature have shown that concomitant sensitization to ubiquitous allergens is frequent in subjects with sensitizer-induced occupational asthma (2) and that occupational asthmatics continue to present persistent symptoms and nonspecific bronchial reactivity for extensive periods of time after diagnosis (3–19 yr), even while away from work (3). Recognition of this is important to encourage appropriate reassignment to different work settings that prevent worsening of disease severity and allow continued gainful employment.

George Piligian, Jamie Szeinuk, Stephen Levin, Jacqueline Moline, Debra Milek, Aboaba Afilaka and Elizabeth Wilk-Rivard

Mount Sinai School of Medicine New York, New York

FOOTNOTES

Conflict of Interest Statement: None of the authors have a financial relationship with a commercial entity that has an interest in the subject of this manuscript.

REFERENCES

  1. Mapp CE, Boschetto P, Maestreli P, Fabbri LM. Occupational asthma. Am J Respir Crit Care Med 2005;172:280–305.[Abstract/Free Full Text]
  2. Maghni K, Lemiere C, Ghezzo H, Yuquan W, Malo JL. Airway inflammation after cessation of exposure to agents causing occupational asthma. Am J Respir Crit Care Med 2004;169:367–372.[Abstract/Free Full Text]
  3. Piirila PL, Nordman H, Keskinen HM, Luukkonen R, Salo SP, Tuomi TO, Tuppurainen M. Long-term follow-up of hexamethylene diisocyanate-, diphenylmethane diisocyanate-, and toluene diisocyanate-induced asthma. Am J Respir Crit Care Med 2000;162:516–522.[Abstract/Free Full Text]




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HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2006 American Thoracic Society