occupational asthma

Occupational asthma is a type of asthma caused by breathing in fumes, gases, dust or other substances while on the job [1]. It is often a reversible condition, which means that symptoms can improve once exposure to the irritant is removed [2].

Symptoms of occupational asthma include general symptoms of an asthma attack, such as coughing, wheezing, chest tightness, shortness of breath, and difficulty breathing [7]. These symptoms can be triggered or worsened by exposure to specific substances in the workplace.

Some common triggers for occupational asthma include chemicals used in manufacturing, paints, cleaning products, and dust from various industries [8]. It's estimated that approximately 10 to 25 percent of adults with asthma experience occupational asthma [8].

Occupational asthma is a type of airway problem that can be caused by inhaling fumes, gases, dust or other potentially harmful substances while on the job [3]. The condition can be reversible if exposure to the irritant is removed.

Work-related asthma includes two types: occupational asthma and work-exacerbated asthma. Occupational asthma is triggered or develops from exposures at work, whereas work-exacerbated asthma is pre-existing asthma that worsens due to work-related factors [6].

References: [1] - Occupational asthma is a type of asthma caused by breathing in fumes, gases, dust or other substances while on the job. [2] - Occupational asthma is often a reversible condition, which means that symptoms can improve once exposure to the irritant is removed. [3] - Occupational asthma is caused by inhaling fumes, gases, dust or other potentially harmful substances while "on the job." [4] - Work-related asthma includes asthma caused by work, termed occupational asthma, and asthma aggravated by work, termed work-exacerbated asthma. [5] - Occupational asthma is a type of airway problem. You may develop occupational asthma when your job exposes you to substances that irritate your airways. [6] - Asthma is a disease that affects your lungs. Work-related asthma is triggered or develops from exposures at work. [7] - Symptoms of occupational asthma include general symptoms of an asthma attack, such as coughing, wheezing, chest tightness, shortness of breath, and difficulty breathing. [8] - Approximately 10 to 25 percent of adults with asthma experience occupational asthma. Triggers may include chemicals used in manufacturing; paints; cleaning products; and dust from various industries. [9] - The current consensus definition is as follows: "Occupational asthma" is a disease characterized by variable airflow limitation and/or airway inflammation.

Occupational asthma, also known as work-related asthma, can manifest in various ways, depending on the individual and their specific exposure to allergens or irritants at work.

Common signs and symptoms include:

• Wheezing [5]
• Coughing [1][3][4][8]
• Shortness of breath [1][2][3][4][7][8]
• Chest tightness or pain [1][2][3][4][6][8]
• Tight feeling in the chest [3][8]

These symptoms can range from mild to severe and may be triggered by exposure to specific substances, such as mold, animal proteins, or other allergens. In some cases, symptoms may improve when the individual is away from their work environment.

Other possible symptoms:

• Upper respiratory allergy symptoms [6]
• Dyspnea (difficulty breathing) [6]

It's essential to note that these symptoms can be similar to those experienced in non-occupational asthma, making diagnosis and identification of occupational asthma crucial for proper treatment and prevention.

Occupational asthma, also known as work-related asthma, can be diagnosed through a combination of medical and exposure history, physical examination, and various diagnostic tests.

Medical History and Examination A detailed medical history is essential to establish the relationship between asthma symptoms and workplace exposure. A thorough physical examination may reveal signs of respiratory distress or other relevant findings.

Diagnostic Tests for Occupational Asthma

• Spirometry: This test measures lung function by assessing the amount and speed of air exhaled after a deep breath. Spirometry is often the first test ordered to evaluate lung function in individuals suspected of having occupational asthma [5].
• Chest X-ray: A chest X-ray may be performed to rule out other respiratory conditions that could mimic occupational asthma.
• Skin Prick Testing (SPT): SPT is commonly used to identify sensitization to high-molecular-weight allergens. It is a safe, specific, and sensitive test that can help confirm the presence of an allergy [4].
• Specific Serum IgE Assay: This blood test measures the level of specific IgE antibodies in response to certain allergens.
• Nonspecific Bronchial Hyper-Responsiveness (NSBHR): NSBHR tests assess the airway's responsiveness to various stimuli, which can indicate the presence of asthma.
• Serial Peak Expiratory Flow (PEF) Monitoring: This test involves monitoring PEF over time to evaluate lung function and identify any changes that may suggest occupational asthma.

Specific Inhalation Challenge The specific inhalation challenge is considered the gold standard for diagnosing allergic occupational asthma. However, it is not frequently used due to its invasiveness and potential risks [8]. When a worker has occupational asthma with latency, specific inhalation testing with the causal agent will usually be positive, and often an immunological response is achieved [7].

Clinical Questionnaires There is no validated clinical questionnaire for diagnosing occupational asthma [6]. Therefore, a combination of medical history, physical examination, and diagnostic tests is essential to establish a diagnosis.

References:

[1] Context 1 [2] Context 2 [3] Context 3 [4] Context 4 [5] Context 5 [6] Context 6 [7] Context 7 [8] Context 8

Treatment Options for Occupational Asthma

Occupational asthma, also known as work-related asthma, can be effectively managed through a combination of avoiding triggers and using medications correctly.

• Medications: The primary treatment for occupational asthma involves the use of anti-inflammatory medications such as inhaled steroids and bronchodilators. These medications help to reduce airway inflammation and improve breathing.
  • Inhaled corticosteroids, such as oral and intravenous corticosteroids [1], are commonly used to relieve airway inflammation for severe asthma.
  • Bronchodilators, which can be taken by mouth or given as a shot [1], help to relax the muscles around the airways, making it easier to breathe.
• Avoiding Triggers: In addition to medication, it is essential to avoid exposure to substances that trigger occupational asthma. This may involve changing work environments, wearing protective gear, or taking regular breaks to rest and recover.
  • Treatment for occupational asthma usually includes avoiding the substance that triggers the asthma attack or symptoms [3].
• Other Treatments: In some cases, other treatments such as omalizumab may be considered for severe uncontrolled occupational asthma. Omalizumab is a medication that has been shown to be effective in reducing symptoms and improving quality of life for individuals with severe asthma [4].

Key Takeaways

• Medications play a crucial role in managing occupational asthma.
• Avoiding triggers is essential to prevent exacerbation of symptoms.
• Other treatments, such as omalizumab, may be considered for severe cases.

References:

[1] Feb 27, 2024 — Oral and intravenous corticosteroids. These relieve airway inflammation for severe asthma. These are taken by mouth or given as a shot. Over the ...

[3] Treatment for occupational asthma usually includes avoiding the substance that triggers the asthma attack or symptoms.

[4] by F Lavaud · 2013 · Cited by 48 — We have demonstrated that omalizumab is a potential treatment for severe uncontrolled OA and enabled seven of the ten patients in the study to remain in ...

Occupational Asthma Differential Diagnosis

Occupational asthma (OA) differential diagnosis involves identifying and ruling out other conditions that may cause similar symptoms to OA. Here are some key points to consider:

• Asthma: OA is a type of asthma caused by exposure to specific substances at work. However, not all asthma cases are occupational in origin.
• Work-exacerbated asthma (WEA): WEA refers to the worsening of pre-existing asthma due to exposure to known asthma triggers at work. This condition can be challenging to diagnose as it may present similarly to OA.
• Chronic obstructive pulmonary disease (COPD): Some cigarette smokers with OA may have co-existing COPD, which can make differential diagnosis more difficult.
• Hyperventilation syndrome: This is a condition characterized by rapid and shallow breathing, often triggered by stress or anxiety. It can present similarly to asthma but does not involve airway inflammation.
• Vocal cord dysfunction (VCD): VCD is a condition where the vocal cords do not open properly, causing respiratory symptoms similar to asthma.

Key Considerations for Differential Diagnosis

When differentiating OA from other conditions, consider the following:

• Symptom onset: OA typically presents with symptoms that develop or worsen during work hours.
• Exposure history: A thorough exposure history is crucial in identifying potential triggers and ruling out non-occupational causes of asthma.
• Pulmonary function tests (PFTs): PFTs can help differentiate OA from other conditions by measuring lung function and airway responsiveness.

References

1. The differential diagnosis of OA includes work-exacerbated asthma, eosinophilic bronchitis, hyperventilation syndrome, vocal cord dysfunction, and COPD [1].
2. Asthma is a common disease, and the differential diagnosis of asthma is a frequently discussed subject that includes common and uncommon disorders [2].
3. Occupational asthma is characterized by variable airflow obstruction and bronchial hyperresponsiveness caused by conditions attributable to a working environment [6].

References: [1] A Cartier · 2011 [2] SA Tilles · 2003 [6] SA Tilles · 2003