A Critical Review of Occupational Asthma in the 21st Century Work Environment

Occupational asthma (OA) is an increasingly relevant respiratory disease in modern workplaces. Epidemiological evidence highlights its considerable prevalence among the global working population, with recent increases following an initial decline in the early 21st century. Objective: To critically review the pathophysiological mechanisms, risk factors, clinical presentations, and emerging challenges associated with OA, focusing on novel exposures, biomarker development, and translation of scientific findings into preventive and clinical practice.

A literature review was conducted through a bibliographic search in PubMed (MEDLINE) and Web of Science. Articles were selected and analyzed using the Rayyan collaborative platform. Empirical studies on prevalence, risk factors, diagnosis, and management of OA were included.

OA is primarily categorized as sensitizer- or irritant-induced, each exhibiting unique molecular pathways and clinical courses. Transcriptomic research has identified specific microRNA profiles as innovative biomarkers with significant diagnostic capacity. Studies document risks in traditionally non-high-risk sectors, such as offices and educational environments. Factors such as work chronobiology (night shifts), sex, and socioeconomic status influence the development and prognosis of OA, potentially leading to loss of productivity and employment.

OA is a significant challenge in occupational health, with complex epidemiological patterns. While advances in molecular characterization and identification of emerging risk factors have improved our understanding of the condition, diagnostic and management challenges persist. Future research should focus on developing specific biomarkers and accessible diagnostic tools for primary care, along with evidence-based preventive strategies for emerging labor sectors.