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Definition and diagnosis of occupational asthma

  • Chapter
Occupational Asthma

Part of the book series: Progress in Inflammation Research ((PIR))

Abstract

Occupational asthma is a disease characterized by variable airflow limitation and/or hyperresponsiveness and/or inflammation due to causes and conditions attributable to a particular occupational environment and not to stimuli encountered outside the workplace. Two types of occupational asthma are distinguished based on their appearance after a latency period or not: the classical occupational asthma requiring a period of sensitization and irritant-induced asthma occurring after acute exposure to high concentrations of irritants. The diagnosis of occupational asthma should be based on objective means and cannot rely only on history (which is, although very sensitive, not sufficiently specific) or even on confirming the presence of asthma with positive skin tests to the relevant allergen/agent found at work. Inquiring about direct or indirect exposure to known sensitizers should be part of the questionnaire of any adult with new onset asthma. Monitoring of peak expiratory flows at and off work is a useful tool but may not be sufficiently sensitive or specific; combining it with monitoring of the provocative concentration of methacoline inducing a 20% fall in FEV1 and possibly sputum induction may improve the accuracy of the diagnosis. Specific inhalation challenges in the laboratory or in the workplace are the reference standard for confirming the diagnosis of occupational asthma. They are safe when done under the close supervision of an expert physician by trained personnel. Any new case of occupational asthma should be considered as a sentinel event.

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Authors and Affiliations

  1. University of Montreal, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, 5400 Boul. Gouin Ouest, Montréal, P.Q., Canada, H4J 1C5

    André Cartier

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  1. André Cartier
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  1. School of Public Health Dept. of Environmental and Occupational Medicine, Aarhus University, Bartholin Allé 2, 8000, Århus C, Denmark

    Torben Sigsgaard

  2. Institute for Risk Assessment Sciences Division of Environmental and Occupational Health, Utrecht University, Yalelaan 2, 3508 TD, Utrecht, Netherlands

    Dick Heederik

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Cartier, A. (2010). Definition and diagnosis of occupational asthma. In: Sigsgaard, T., Heederik, D. (eds) Occupational Asthma. Progress in Inflammation Research. Birkhäuser Basel. https://doi.org/10.1007/978-3-7643-8556-9_5

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  • DOI: https://doi.org/10.1007/978-3-7643-8556-9_5

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