Occupational Asthma Reference

Henneberger PK, Redlich CA, Callahan DB, Harber P, Lemière C, Martin J, Tarlo SM, Vandenplas O, An Official American Thoracic Society Statement: Work-Exacerbated Asthma, Am J Respir Crit Care Med, 2011;184:368-378,
(Plain text: Henneberger PK, Redlich CA, Callahan DB, Harber P, Lemiere C, Martin J, Tarlo SM, Vandenplas O, An Official American Thoracic Society Statement: Work-Exacerbated Asthma, Am J Respir Crit Care Med)

Keywords: review, ATS, work exacerbated asthma

Known Authors

Paul Henneberger, NIOSH, Morgantown, USA Paul Henneberger

Olivier Vandenplas, Universite Mont-Goginne, Yvoir Olivier Vandenplas

Carrie Redlich, Yale University, Newhaven Connecticut Carrie Redlich

Catherine Lemière, Hôpital de Sacré Coeur, Montreal, Quebec, Canada Catherine Lemière

Susan Tarlo, Toronto Susan Tarlo

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Rationale: Occupational exposures can contribute to the exacerbation as well as the onset of asthma. However, work-exacerbated asthma (WEA) has received less attention than occupational asthma (OA) that is caused by work.

Objectives: The purpose of this Statement is to summarize current knowledge about the descriptive epidemiology, clinical characteristics, and management and treatment of WEA; propose a case definition for WEA; and discuss needs for prevention and research.

Methods: Information about WEA was identified primarily by systematic searches of the medical literature. Statements about prevention and research needs were reached by consensus.

Measurements and Main Results: WEA is defined as the worsening of asthma due to conditions at work. WEA is common, with a median prevalence of 21.5% among adults with asthma. Different types of agents or conditions at work may exacerbate asthma. WEA cases with persistent work-related symptoms can have clinical characteristics (level of severity, medication needs) and adverse socioeconomic outcomes (unemployment, reduction in income) similar to those of OA cases. Compared with adults with asthma unrelated to work, WEA cases report more days with symptoms, seek more medical care, and have a lower quality of life. WEA should be considered in any patient with asthma that is getting worse or who has work-related symptoms. Management of WEA should focus on reducing work exposures and optimizing standard medical management, with a change in jobs only if these measures are not successful.

Conclusions: WEA is a common and underrecognized adverse outcome resulting from conditions at work. Additional research is needed to improve the understanding of the risk factors for, and mechanisms and outcomes of, WEA, and to inform and evaluate preventive interventions.

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