Skip to main content
Log in

Risk Factors, Predictors, and Markers for Work-related Asthma and Rhinitis

  • Published:
Current Allergy and Asthma Reports Aims and scope Submit manuscript

Abstract

The burden of asthma attributable to occupational exposures is significant. A better evaluation of markers of asthma and rhinitis in occupational settings may help reduce the frequency of occupational asthma (OA) and rhinitis (OR). This publication reviews articles published in 2008 and 2009 to provide an update on aspects related to markers of asthma and rhinitis. Markers derived from occupational exposure assessment, questionnaires, clinical data, and noninvasive tests such as functional tests or measures of serum antibodies are used to develop prediction models for the likelihood of OA and OR development. Findings from prospective studies highlight the course of preclinical signs and markers of airway inflammation in the natural history of OA and OR. Airway inflammation, evaluated by quantification of cells and mediators in induced sputum or nasal lavage and by exhaled nitric oxide, is associated with OA and OR; however, the sensitivity and specificity of these means, especially exhaled nitric oxide, have not been sufficiently assessed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Moscato G, Vandenplas O, Gerth Van Mijk R, et al.: Occupational rhinitis. Allergy 2008, 63:969–980

    Article  CAS  PubMed  Google Scholar 

  2. Bernstein IL, Chan-Yeung M, Malo JL, Berstein DI: Asthma in the Workplace, edn 3. New York: Taylor & Francis; 2006.

    Google Scholar 

  3. Siracusa A, Desrosiers M, Marabini A: Epidemiology of occupational rhinitis: prevalence, aetiology and determinants. Clin Exp Allergy 2000, 30:1519–1534.

    Article  CAS  PubMed  Google Scholar 

  4. Seed MJ, Gittins M, DeVocht F, Agius RM: Occupational rhinitis and occupational asthma; one airway two diseases? J Phys Conf Series 2009, 151:12–65.

    Article  Google Scholar 

  5. Tarlo SM, Balmes J, Balkisssoon R, et al.: ACCP Consensus Statement: diagnosis and management of work-related asthma. Chest 2008, 134:1 S–41 S.

    Article  CAS  PubMed  Google Scholar 

  6. •• Tarlo SM, Malo JL, Third Jack Pepys Workshop on Asthma in the Workplace Participants: An official ATS proceedings: asthma in the workplace: the Third Jack Pepys Workshop on Asthma in the Workplace: answered and unanswered questions. Proc Am Thorac Soc 2009, 6:339–349. This was a report on a 3-yearly held symposium that covers many relevant aspects of asthma (and rhinitis) in the workplace.

    Article  PubMed  Google Scholar 

  7. Hellgren J: Occupational rhinosinusitis. Curr Allergy Asthma Rep 2008, 8:234–239.

    Article  PubMed  Google Scholar 

  8. •• Toren K, Blanc P: Asthma caused by occupational exposures is common—a systematic analysis of estimates of the population-attributable fraction. BMC Pulm Med 2009, 9:7. This is an update of the 1999 classical and often-quoted meta-analysis (see Blanc and Toren [9]).

    Article  PubMed  Google Scholar 

  9. Blanc PD, Toren K: How much asthma can be attributed to occupational factors? Am J Med 1999, 107:580–587.

    Article  CAS  PubMed  Google Scholar 

  10. Demir A, Joseph L, Becklake MR: Work-related asthma in Montreal, Quebec: population attributable risk in a community-based study. Can Respir J 2008, 15:406–412.

    PubMed  Google Scholar 

  11. Bakerly ND, Moore VC, Vellore AD, et al.: Fifteen-year trends in occupational asthma: data from the Shield surveillance scheme. Occup Med (Lond) 2008, 58:169–174.

    Article  Google Scholar 

  12. Vandenplas O, Larbanois A, Vanassche F, et al.: Latex-induced occupational asthma: time trend in incidence and relationship with hospital glove policies. Allergy 2009, 64:415–420.

    Article  CAS  PubMed  Google Scholar 

  13. Mazurek JM, Filios M, Willis R, et al.: Work-related asthma in the educational services industry: California, Massachusetts, Michigan, and New Jersey, 1993-2000. Am J Ind Med 2008, 51:47–59.

    Article  PubMed  Google Scholar 

  14. Hur GH, Koh DH, Kim HA, et al.: Prevalence of work-related symptoms and serum-specific antibodies to wheat flour in exposed workers in the bakery industry. Respir Med 2008, 102:548–555.

    Article  PubMed  Google Scholar 

  15. Jeebhay MF, Robins TG, Miller ME, et al.: Occupational allergy and asthma among salt water fish processing workers. Am J Ind Med 2008, 51:899–910.

    Article  PubMed  Google Scholar 

  16. Hur GY, Koh DH, Choi GS, et al.: Clinical and immunologic findings of methylene diphenyl diisocyanate-induced occupational asthma in a car upholstery factory. Clin Exp Allergy 2008, 38:586–593.

    Article  CAS  PubMed  Google Scholar 

  17. Wisnewski A, Redlich CA, Mapp CE, Bernstein DI: Polyisocyanates and their prepolymers. In Asthma in the Workplace, edn 3. Edited by Bernstein IL, Chan-Yeung M, Malo JL, Bernstein DI. New York: Taylor & Francis; 2006:481–504.

    Google Scholar 

  18. Obadia M, Liss GM, Lou W, et al.: Relationships between asthma and work exposures among non-domestic cleaners in Ontario. Am J Ind Med 2009, 52:716–723.

    Article  PubMed  Google Scholar 

  19. Kaukiainen A, Martikainen R, Riala R, et al.: Work tasks, chemical exposure and respiratory health in construction painting. Am J Ind Med 2008, 51:1–8.

    Article  PubMed  Google Scholar 

  20. Arif AA, Delclos GL, Serra C: Occupational exposures and asthma among nursing professionals. Occup Environ Med 2009, 66:274–278.

    Article  CAS  PubMed  Google Scholar 

  21. Heikkilä P, Martikainen R, Kurppa K, et al.: Asthma incidence in wood-processing industries in Finland in a register-based population study. Scand J Work Environ Health 2008, 34:66–72.

    PubMed  Google Scholar 

  22. •• Gautrin D, Ghezzo H, Infante-Rivard C, et al.: Long-term outcomes in a prospective cohort of apprentices exposed to high-molecular-weight agents. Am J Respir Crit Care Med 2008, 177:871–879. This was the first long-term prospective study of a cohort of apprentices exposed to HMW agents describing the natural history of probable OA and related outcomes 8 years after completing training in a vocational school and with continued exposure to HMW allergens.

    Article  PubMed  Google Scholar 

  23. • Dragos M, Jones M, Malo JL, et al.: Specific antibodies to diisocyanate and work-related respiratory symptoms in apprentice car-painters. Occup Environ Med 2009, 66:227–234. This was a longitudinal study of a large cohort of apprentices investigating changes in isocyanate-specific IgE and IgG antibodies in relation to duration of exposure and incidence of work-related symptoms.

    Article  CAS  PubMed  Google Scholar 

  24. Jacobs JH, Meijster T, Meijer E, et al.: Wheat allergen exposure and the prevalence of work-related sensitization and allergy in bakery workers. Allergy 2008, 63:1597–1604.

    Article  CAS  PubMed  Google Scholar 

  25. Meijster T, Tielemans E, de Pater N, Heederik D: Modelling exposure in flour processing sectors in the Netherlands: a baseline measurement in the context of an intervention program. Ann Occup Hyg 2007, 51:293–304.

    Article  CAS  PubMed  Google Scholar 

  26. Pronk A, Preller L, Raulf-Helmsoth M, et al.: Respiratory symptoms, sensitization, and exposure-response relationships in spray painters exposed to isocyanates. Am J Respir Crit Care Med 2007, 176:1090–1097.

    Article  CAS  PubMed  Google Scholar 

  27. Howse D, Gautrin D, Neis B, et al.: Gender and snow crab occupational asthma in Newfoundland and Labrador, Canada. Environ Res 2006, 101:163–174.

    Article  CAS  PubMed  Google Scholar 

  28. •• Gautrin D, Cartier A, Howse D, et al.: Occupational asthma and allergy in snow crab processing in Newfoundland and Labrador. Occup Environ Med 2010, 67:17–23. This article reports on the high prevalence of probable OA and allergy to snow crab and its relationship to exposure to snow crab allergens; the work described is part of a large multidisciplinary project on snow crab asthma and allergy on Canada's East Coast.

    Article  CAS  PubMed  Google Scholar 

  29. Kennedy SM, Le Moual N, Choudat D, Kauffmann F: Development of an asthma specific job exposure matrix and its application in the epidemiological study of genetics and environment in asthma (EGEA). Occup Environ Med 2000, 57:635–641.

    Article  CAS  PubMed  Google Scholar 

  30. Delclos GL, Gimeno D, Arif AA, et al.: Occupational exposures and asthma in health-care workers: comparison of self-reports with a workplace-specific job exposure matrix. Am J Epidemiol 2009, 169:581–587.

    Article  PubMed  Google Scholar 

  31. • Suarthana E, Heederik D, Ghezzo H, et al.: Risks for the development of outcomes related to occupational allergies: an application of the asthma-specific job exposure matrix compared with self-reports and investigator scores on job-training-related exposure. Occup Environ Med 2009, 66:256–263. This paper describes the application of the asthma-specific JEM to outcomes related to asthma in the workplace and considered as markers of early manifestations of the disease.

    Article  CAS  PubMed  Google Scholar 

  32. Gautrin D, Bernstein IL, Brooks SM, Henneberger PK: Reactive airways dysfunction syndrome and irritant-induced asthma. In Asthma in the Workplace, edn 3. Edited by Bernstein IL, Chan-Yeung M, Malo JL, Bernstein DI. New York: Taylor & Francis; 2006:579–627.

    Google Scholar 

  33. Radon K, Huemmer S, Dressel H, et al.: Do respiratory symptoms predict job choices in teenagers? Eur Respir J 2006, 27:774–778.

    Article  CAS  PubMed  Google Scholar 

  34. Wiebert P, Svartengren M, Lindberg M, et al.: Mortality, morbidity and occupational exposure to airway-irritating agents among men with a respiratory diagnosis in adolescence. Occup Environ Med 2008, 65:120–125.

    Article  CAS  PubMed  Google Scholar 

  35. Mapp CE: What is the role of genetics in occupational asthma? Eur Respir J 2009, 33:459–460.

    Article  CAS  PubMed  Google Scholar 

  36. Ober C, Thompson EE: Rethinking genetic models of asthma: the role of environmental modifiers. Curr Opin Immunol 2005, 17:670–678.

    Article  CAS  PubMed  Google Scholar 

  37. Christiani DC, Mehta AJ, Yu CL: Genetic susceptibility to occupational exposures. Occup Environ Med 2008, 65:430–436.

    Article  CAS  PubMed  Google Scholar 

  38. Becklake MR, Chan-Yeung M, Malo JL: Epidemiological approaches in occupational asthma. In Asthma in the Workplace, edn 3. Edited by Bernstein IL, Chan-Yeung M, Malo JL, Bernstein DI. New York: Taylor & Francis; 2006:37–85.

    Google Scholar 

  39. Marraccini P, Brass DM, Hollingsworth JW, et al.: Bakery flour dust exposure causes non-allergic inflammation and enhances allergic airway inflammation in mice. Clin Exp Allergy 2008, 38:1526–1535.

    Article  CAS  PubMed  Google Scholar 

  40. Krop EJM, Heederik DJJ, Lutter R, et al.: Associations between pre-employment immunologic and airway mucosal factors and the development of occupational allergy. J Allergy Clin Immunol 2009, 123:694–700.

    Article  CAS  PubMed  Google Scholar 

  41. Cartier A: Definition and diagnosis of occupational asthma. Eur Respir J 1994, 7:153–160.

    Article  CAS  PubMed  Google Scholar 

  42. Gautrin D, Infante-Rivard C, Ghezzo H, Malo JL: Incidence and host determinants of probable occupational asthma in apprentices exposed to laboratory animals. Am J Respir Crit Care Med 2001, 163:899–904.

    CAS  PubMed  Google Scholar 

  43. Suarthana E, Malo JL, Heederik D, et al.: Which tools best predict the incidence of work-related sensitisation and symptoms. Occup Env Med 2009, 66:111–117.

    Article  CAS  Google Scholar 

  44. Tiikkainen U, Klockars M: Determination of IgG subclass antibodies against wheat flour antigens by an ELISA technique. Allergy 1989, 44:419–426.

    Article  CAS  PubMed  Google Scholar 

  45. Gill BV, Rice TR, Cartier A, et al.: Identification of crab proteins that elicit IgE reactivity in snow crab-processing workers. J Allergy Clin Immunol 2009, 124:1055–1061.

    Article  CAS  PubMed  Google Scholar 

  46. Rizzo R, Mapp CE, Melchiorri L, et al.: Defective production of soluble HLA-G molecules by peripheral blood monocytes in patients with asthma. J Allergy Clin Immunol 2005, 115:508–513.

    Article  CAS  PubMed  Google Scholar 

  47. Mapp CE, Ferrazzoni S, Rizzo R, et al.: Soluble human leucocyte antigen-G and interleukin-10 levels in isocyanate-induced asthma. Clin Exp Allergy 2009, 39:812–819.

    Article  CAS  PubMed  Google Scholar 

  48. Tossa P, Bohadana A, Demange V, et al.: Early markers of airways inflammation and occupational asthma: rationale, study design and follow-up rates among bakery, pastry and hairdressing apprentices. BMC Public Health 2009, 9:113.

    Article  PubMed  Google Scholar 

  49. Quirce S, Lemière C, deBlay F, et al.: Noninvasive methods for assessment of airway inflammation in occupational settings. Allergy 2010, 65:445–458.

    Article  CAS  PubMed  Google Scholar 

  50. •• Castano R, Gautrin D, Thériault C, et al.: Occupational rhinitis in workers investigated for occupational asthma. Thorax 2009, 64:50–54. This paper represents the most extensive account of the clinical confirmation of OR by objective assessment.

    Article  CAS  PubMed  Google Scholar 

  51. Castano R, Thériault G, Maghni K, et al.: Reproducibility of nasal lavage in the context of the inhalation challenge investigation of occupational rhinitis. Am J Rhinol 2008, 22:271–275.

    Article  PubMed  Google Scholar 

  52. Pignatti P, Pala G, Pisati M, et al.: Nasal blown secretion evaluation in specific occupational nasal challenges. Int Arch Occup Environ Health 2010, 83:217–223.

    Article  PubMed  Google Scholar 

Download references

Disclosure

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Denyse Gautrin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gautrin, D., Malo, JL. Risk Factors, Predictors, and Markers for Work-related Asthma and Rhinitis. Curr Allergy Asthma Rep 10, 365–372 (2010). https://doi.org/10.1007/s11882-010-0131-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11882-010-0131-1

Keywords

Navigation