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Occupational asthma: a practical approach.

M S Dykewicz1

  • 1Department of Internal Medicine, Division of Allergy and Immunology, Saint Louis University School of Medicine, 1402 S. Grand Boulevard R209, St. Louis, MO 63104, USA.

Allergy and Asthma Proceedings
|September 13, 2001
PubMed
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Diagnosing occupational asthma requires a systematic approach, combining detailed patient history with objective tests like spirometry and specific IgE or IgG antibody levels. Early intervention and avoidance of workplace triggers are crucial for preventing long-term lung impairment.

Area of Science:

  • Occupational Medicine
  • Pulmonology
  • Allergy and Immunology

Background:

  • Occupational asthma diagnosis is complex, often relying on patient history, which can be unreliable.
  • Distinguishing workplace-induced asthma from non-occupational causes requires a structured evaluation.

Purpose of the Study:

  • To outline a systematic approach for diagnosing occupational asthma.
  • To emphasize the importance of objective measurements alongside clinical history.
  • To guide intervention and disability assessment for occupational asthma.

Main Methods:

  • Systematic assessment including presence of asthma and workplace causality.
  • Detailed occupational and medical history.
  • Objective measurements: spirometry, peak flow, skin testing, in vitro IgE/IgG antibody tests, specific inhalation challenges.

Related Experiment Videos

  • Assessment of permanent impairment after 2 years of exposure removal.

    • Main Results:

    • Detailed histories alone can lead to diagnostic inaccuracies.
    • Work-related changes in spirometry/peak flow can confirm diagnosis in current workers.
    • Specific IgE tests are useful for some sensitizers, while IgG levels may correlate better for isocyanates.
    • Controlled inhalation tests require expert supervision.

    Conclusions:

    • A comprehensive, objective approach is essential for accurate occupational asthma diagnosis.
    • Prompt intervention focused on exposure reduction is key to preventing chronic lung disease.
    • Disability assessment should occur after maximal medical improvement is achieved post-exposure cessation.