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Clinical evaluation of occupational asthma
G Moscato1, L Perfetti, E Galdi
1Medical Center of Pavia, Dept of Allergy and Clinical Immunology, Specialization School of Allergology and Clinical Immunology, University of Pavia, Italy.
Summary
Diagnosing occupational asthma (OA) involves a stepwise approach. This includes confirming asthma symptoms, assessing bronchial obstruction and hyperresponsiveness, and linking them to workplace exposures for accurate diagnosis.
Area of Science:
- Occupational Medicine
- Pulmonology
- Immunology
Background:
- Occupational asthma (OA) is a common subtype characterized by variable bronchial obstruction and hyperresponsiveness.
- Symptoms arise after a latency period following workplace exposure to specific inhaled agents.
Purpose of the Study:
- To discuss the diagnostic procedures for occupational asthma.
- To outline a stepwise clinical investigation approach for OA.
Main Methods:
- Comprehensive patient history and clinical investigation.
- Physiological studies including peak expiratory flow (PEF) variability and bronchial hyperreactivity assessment.
- Immunological studies such as skin tests and specific immunoglobulin E (IgE) testing for suspected agents.
Main Results:
- A stepwise diagnostic process confirms asthma and links it to workplace triggers.
- Serial PEF monitoring and bronchial hyperreactivity tests help establish work-relatedness.
- Specific tests (skin, IgE, inhalation challenge) identify causative agents, especially for low-molecular-weight substances.
Conclusions:
- Accurate diagnosis of OA relies on a systematic approach combining clinical, physiological, and immunological assessments.
- Identifying specific workplace agents is crucial for effective management and prevention of OA.