Novel approaches in occupational asthma diagnosis and management.

Abstract:

PURPOSE OF REVIEW:To describe the recent findings of the last 2 years on the epidemiology and phenotypes of occupational asthma, as well as new developments in its diagnosis and management. RECENT FINDINGS:Data from nine longitudinal studies showed a population attributable fraction for the occupational contribution to incident asthma of 16%. The main phenotypes of occupational asthma are: occupational asthma caused by high-molecular-weight (HMW) or low-molecular-weight (LMW) agents, irritant-induced asthma and occupational asthma-chronic obstructive pulmonary disease overlap. Among the variety of causative agents of occupational asthma, food-derived components are increasingly being reported, accounting for up to 25% cases of occupational asthma and/or occupational rhinitis. Recently, a specific inhalation challenge (SIC)-independent model has been developed to calculate the probability of occupational asthma diagnosis in workers exposed to HMW agents. In this model, work-specific sensitization, bronchial hyperresponsiveness, inhaled corticosteroid use, rhinoconjunctivitis and age 40 years or less were the most relevant predictive factors. Specific IgE measurements showed a pooled sensitivity of 0.74 and a specificity of 0.71 in the diagnosis of occupational asthma for HMW agents, while a lower sensitivity (0.28) and a higher specificity (0.89) was shown for LMW agents. Cessation of exposure to workplace sensitizers is the cornerstone of management of work-related conditions. SUMMARY:An early and precise diagnosis of occupational asthma is crucial, allowing appropriate management and implementation of preventive strategies.

journal_name

Curr Opin Pulm Med

authors

Quirce S,Domínguez-Ortega J,Luna JA

doi

10.1097/MCP.0000000000000737

subject

Has Abstract

pub_date

2021-01-01 00:00:00

pages

9-14

issue

1

eissn

1070-5287

issn

1531-6971

journal_volume

27

pub_type

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