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Occupational asthma due to low molecular weight agents
F Di Stefano1, N Verna, L Di Giampaolo
1Department of Medicine and Science of Aging, Section of Allergy, Clinical Immunology and Occupational Medicine, University G. D'Annunzio, Chieti, Italy. distefa.fabio@tiscali.it
International Journal of Immunopathology and Pharmacology
|September 4, 2004
Summary
Occupational asthma, caused by workplace exposures like isocyanates, requires objective diagnosis beyond history. Early detection and workplace interventions are key for prevention and managing this condition.
Area of Science:
- Occupational Medicine
- Immunology
- Pulmonology
Background:
- Occupational asthma involves variable airflow obstruction and airway hyperresponsiveness due to workplace agents.
- Low molecular weight agents, including isocyanates, aldehydes, and anhydrides, are increasingly implicated.
- Some agents can cause sensitization via an immunoglobulin E (IgE) mediated response, acting as haptens.
Purpose of the Study:
- To define occupational asthma and discuss its increasing causative agents.
- To review diagnostic methods, including objective confirmations.
- To highlight prevention strategies and the importance of medical surveillance.
Main Methods:
- Review of causative agents and mechanisms of occupational asthma.
- Discussion of diagnostic approaches: suggestive history, objective lung function monitoring (peak expiratory flow rate, bronchial hyperresponsiveness), and specific bronchoprovocation tests.
- Emphasis on the 'gold standard' specific bronchoprovocation test for agents like isocyanates.
Main Results:
- Low molecular weight agents are a growing cause of occupational asthma.
- Specific IgE assays have limitations in sensitivity.
- Objective diagnostic methods, particularly specific bronchoprovocation tests, are crucial for confirmation.
Conclusions:
- Occupational asthma diagnosis requires objective confirmation beyond patient history.
- No individual risk factors predict susceptibility; primary prevention focuses on workplace interventions.
- Strict medical surveillance aids early diagnosis and prevents long-term disability.