Materiały źródłowe

• #1 Standards of care for occupational asthma | Thorax

  https://thorax.bmj.com/content/63/3/240

  Occupational asthma remains a common disease in the UK with up to 3000 new cases diagnosed each year. […] The prognosis of individuals with occupational asthma is better if they are removed from exposure quickly, particularly within a year of first symptoms. […] Health surveillance can detect occupational asthma at an earlier stage of disease and the outcome is improved in workers who are included in a health surveillance programme. […] The symptoms and functional impairment of occupational asthma caused by various agents may persist for years after avoidance of further exposure to the causative agent. […] The likelihood of improvement or resolution of symptoms or of preventing deterioration is greater in workers who have no further exposure to the causative agent. […] Redeployment to a low exposure area may lead to improvement or resolution of symptoms or prevent deterioration in some workers, but is not always effective. […] Approximately one-third of workers with occupational asthma are unemployed up to 6 years after diagnosis. […] Workers with occupational asthma suffer financially.

• #2 Progress in Occupational Asthma

  https://www.mdpi.com/1660-4601/17/12/4553

  Occupational asthma (OA) represents one of the major public health problems due to its high prevalence, important social and economic burden. […] The aim of this review is to summarize current data about clinical phenotypes, biomarkers, diagnosis and management of OA, a subtype of work-related asthma. […] The best diagnostic approach for OA is a combination of clinical history and objective tests. […] An important tool is a specific inhalation challenge. […] Treatment of OA implies avoidance of exposure, pharmacotherapy and education. […] OA is a heterogeneous disease. […] Mechanisms of its different phenotypes, their diagnosis, role of new biomarkers and treatment require further investigation. […] The classic presentation of SI-OA is a worker who develops asthma symptoms that are worse at work and better on weekends or vacations away from work.

• #3 Prognosis of occupational asthma – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8005260/

  Several studies on the prognosis of occupational asthma have shown that a significant proportion of patients continue to experience asthmatic symptoms and nonspecific bronchial hyperresponsiveness after cessation of work. The determinants of this unfavourable prognosis of asthma are: long duration of exposure before the onset of asthma; long duration of symptoms before diagnosis; baseline airway obstruction; dual response after specific challenge test; and the persistence of markers of airway inflammation in bronchoalveolar lavage fluid and bronchial biopsy. […] Further occupational exposure in sensitized subjects leads to persistence and sometimes to progressive deterioration of asthma, irrespective of the reduction of exposure to the specific sensitizer, and only the use of particular protective devices effectively prevents the progression of the disease.

• #4 British Thoracic Society Clinical Statement on occupational asthma | Thorax

  https://thorax.bmj.com/content/77/5/433

  Around one in six patients with OA meet established criteria for severe asthma. […] Prognosis in OA is largely determined by asthma severity at the time of diagnosis, and whether workers continue to be exposed to the cause thereafter. […] Around 25%–30% of OA patients who permanently cease exposure will make a full recovery, and another 30%–35% will report a reduction in symptoms with treatment. […] Patients with OA who remain exposed to the cause are at risk of accelerated lung function decline, which may result in a degree of fixed airflow obstruction. […] Patients with OA have an increased risk of unemployment, with approximately one in three being out of work 35 years after diagnosis. […] Anxiety and depression are common in OA, affecting up to half of patients.

• #5 Progress in Occupational Asthma

  https://www.mdpi.com/1660-4601/17/12/4553

  The best diagnostic approach for OA is to combine a detailed clinical history with objective diagnostic tests. […] Once a sensitizer-induced OA is confirmed, early removal of the workers from exposure is associated with a better prognosis and outcomes. […] Complete avoidance is more effective than partial mitigation. […] Primary, secondary and tertiary prevention are mandatory in the management of sensitizer-induced OA. […] Patients with irritant-induced OA may continue to work if their respiratory symptoms are controlled with appropriate treatment. […] The pharmacologic therapy relies on a stepwise approach (similar to asthma management non-related to work), with the goal of obtaining and maintaining asthma control.

• #6 Prognosis of occupational asthma – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8005260/

  A long-term follow-up study of toluene diisocyanate (TDI)-induced asthma showed that the improvement in bronchial hyperresponsiveness to methacholine occurred in a small percentage of subjects and only a long time after work cessation. Bronchial sensitivity to TDI may disappear, but non-specific bronchial hyperresponsiveness often persists unchanged, suggesting a permanent deregulation of airway tone. Steroid treatment significantly reduces nonspecific bronchial hyperresponsiveness only when started immediately after diagnosis.

• #7 Occupational asthma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/occupational-asthma/symptoms-causes/syc-20375772

  Occupational asthma is a type of asthma caused by breathing in fumes, gases, dust or other substances while on the job. […] If occupational asthma is not treated and triggers are not avoided, the asthma can cause permanent changes to the lungs. […] The longer you’re exposed to a substance that can cause occupational asthma, the worse your symptoms may become. Also, the longer you’re exposed, the longer it will take for symptoms to improve after exposure stops. In some cases, exposure to airborne asthma triggers can cause permanent changes to your lungs. […] Medicines may help relieve symptoms and control inflammation linked to occupational asthma.

• #8 #asthma #occupation #prediction #diagnostic #research | Eva Suarthana

  https://www.linkedin.com/posts/eva-suarthana-58ba572b_asthma-occupation-prediction-activity-7215331803870416897-yE0S

  Thank you, the National Research and Innovation Agency (BRIN) of the Republic Indonesia Badan Riset dan Inovasi Nasional RI (BRIN RI) for the opportunity to share our work on the development, evaluation, and dissemination of clinical prediction tools for occupational asthma (late post). Occupational asthma has a profound impact on the workers’ quality of life and work productivity. Yet, the diagnosis remains a challenge. […] Access to our free online calculator for occupational asthma due to high molecular weight agents: https://lnkd.in/gBufe5Aa […] Access to webinar recording that also includes great presentations by Dr. Ivo SahBandar LaRocque about the role of molecular testing for cancer diagnosis and treatment and Dr. Anthony P. Sunjaya about digital health tools and AI for non-communicable diseases: https://lnkd.in/g9hAEags

• #9 Impact of occupational asthma on health and employment status: a long-term follow-up study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/36581454/

  Objectives: The aim of this study was to assess the predictors of a favourable prognosis of occupational asthma (OA) and the employment status of patients with OA at least 2 years after diagnosis. […] At follow-up, three individuals have retired; among the remaining 57 workers, 91.2% were still employed and 43.8% of them had continued working in the same factory after ceasing exposure to the causative agent. […] This monocentric study did not identify a strong predictor of OA remission, but documented a high employment rate and a good job preservation over a long timeframe after diagnosis of OA mainly induced by low molecular weight agents.

• #10 Progress in Occupational Asthma

  https://www.mdpi.com/1660-4601/17/12/4553

  A variable latency period ranging from weeks to years after the first exposure to the sensitizer is observed before the onset of respiratory symptoms. […] When performing a specific inhalation challenge (SIC) the reaction to HMW agents is positive after a shorter exposure time and requires higher doses of rescue medications but the bronchial hyperresponsiveness (BHR) detected after SIC is milder than after exposure to LMWA. […] Due to this difference in the pathogenesis, the response to controller medication as well as the long term prognosis is different according to the causative agent. […] These patients have milder course of the disease and often can continue working. […] The prevalence of II-OA is estimated at 5–10% of cases of OA. […] The diagnostic criteria for RADS firstly established by Brooks were adapted and include now: the occurrence of asthma symptoms within minutes to hours <24 h following a single identifiable high level exposure to an irritant, the absence of preexisting asthma symptomatology, the exclusion of other pulmonary disorders that can explain the symptoms, and the evidence of BHR or reversible airflow obstruction on spirometry.

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