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Published ahead of print on April 28, 2005, doi:10.1164/rccm.200311-1575SO

Am. J. Respir. Crit. Care Med., Volume 172, Number 3, August 2005, 280-305

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Submitted on November 19, 2003
Accepted on April 25, 2005

Occupational Asthma

Cristina E Mapp1*, Piera Boschetto1, Piero Maestrelli2, and Leonardo M Fabbri3

1 Department of Clinical and Experimental Medicine, Section of Hygiene and Occupational Medicine, University of Ferrara, Ferrara, Italy, 2 Department of Environmental Medicine and Public Health, University of Padova, Padova, Italy, 3 Department of Oncology and Haematology, Section of Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy

* To whom correspondence should be addressed. E-mail: map{at}dns.unife.it.

Substantial epidemiological and clinical evidence indicates that agents inhaled at work can induce asthma. In industrialized countries, occupational factors have been implicated in 9-15% of all cases of adult asthma. Work-related asthma includes: 1. immunological occupational asthma (OA), characterized by a latency period before the onset of symptoms; 2. nonimmunological OA, which occurs after single or multiple exposures to high concentrations of irritant materials; 3. work-aggravated asthma, which is pre-existing or concurrent asthma exacerbated by workplace exposures; 4. variant syndromes. Assessment of the work environment has improved in recent years, making it possible to measure concentrations of several high- and low-molecular-weight agents in the workplace. The identification of host factors, polymorphisms, and candidate genes associated with OA is in progress and may improve our understanding of mechanisms involved in OA. A reliable diagnosis of OA should be confirmed by objective testing early after its onset. Removal of the worker from exposure to the causal agent and treatment with inhaled glucocorticoids lead to a better outcome. Finally, strategies for preventing OA should be implemented and their cost-effectiveness examined.
Key words: asthma, workplace, risk, susceptibility, management




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