Progress in Occupational Asthma.

Area of Science:

• Pulmonology
• Occupational Medicine
• Immunology

Background:

• Occupational asthma (OA) is a prevalent work-related respiratory condition with substantial socioeconomic impact.
• Identifying and managing OA is crucial for public health.
• Over 400 causative agents for OA have been identified, with new ones continually emerging.

Purpose of the Study:

• To review current knowledge on clinical phenotypes, biomarkers, diagnosis, and management of occupational asthma.
• To consolidate information on the two primary OA phenotypes: sensitizer-induced and irritant-induced asthma.

Main Methods:

• Literature review summarizing existing data on OA.
• Analysis of diagnostic approaches, including clinical history, specific inhalation challenges, bronchial hyperresponsiveness tests, peak expiratory flow monitoring, sputum eosinophils, exhaled nitric oxide, skin prick tests, and serum specific IgE.
• Examination of treatment strategies encompassing exposure avoidance, pharmacotherapy, and patient education.

Main Results:

• Two main OA phenotypes identified: sensitizer-induced (latency period, hypersensitivity) and irritant-induced (no latency, high concentration exposure).
• A combination of clinical history and objective tests, particularly specific inhalation challenges, is optimal for diagnosis.
• Various objective tests aid in diagnosis, including bronchial hyperresponsiveness, peak flow monitoring, and biomarkers like sputum eosinophils and exhaled nitric oxide.

Conclusions:

• Occupational asthma is a heterogeneous disease requiring further research into its varied phenotypes, diagnostic advancements, and novel biomarkers.
• Effective management hinges on accurate diagnosis, avoidance of occupational triggers, appropriate pharmacotherapy, and patient education.