Occupational Asthma

موضوع: Occupational Asthma الأربعاء سبتمبر 12, 2007 8:06 pm

Introduction

Occupational asthma is the most common occupational lung disease. It is estimated that 15 per cent of all adult onset asthma is due to occupational asthma.
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Prognosis

Prognosis is directly related to the duration of time between onset of symptoms and removal of the cause. The earlier it is recognised and treated, the better the prognosis for the patients.
In addition to those people who have asthma caused only by a work exposure, GPs see many asthmatics whose asthma is aggravated by workplace exposure.
Asthma Australia in conjunction with the WA Research Unit of the RACGP (WA) has produced a summary of the issues involved and a practical guide to suspecting, diagnosing and managing occupational asthma in general practice. An outline summary is below.
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Suspect

GPs need to ask adult asthmatic patients one important question: ìTell me about your work?' Suspect occupational asthma in:

Any newly diagnosed adult asthmatic.
Any patient with cough or wheeze that improves on weekends or on holidays.
Any patient working in a high risk occupation, especially if they have other symptoms of atopy.
Otherwise unexplained exacerbation of previously well controlled asthma.

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Workplace review

All aspects of a patient's job, including work processes in adjacent areas, should be reviewed to try to identify exposure to sensitising agents. There are more than 250 agents suspected of causing occupational asthma, and the list is growing. At risk occupations include spray painters, agricultural workers, bakers, health workers (allergy to latex gloves) animal handlers and hairdressers.
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Diagnosis in general practice

Diagnosis is by history and correlation of the airflow limitation with the work exposure. This is best achieved by serial peak flow monitoring at work and at home for a period of at least two weeks.
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Management

Management of occupational asthma involves treatment of the asthma and removal or reduction of the exposure.
The keystone of treatment is removal from exposure. Studies have shown a direct link between length of time of exposure and persisting asthma. Reduction and removal of exposure is also important for those asthmatics whose asthma is exacerbated by workplace exposure.
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Treatment of the asthma

Occupational asthma is treated like other asthma, following the six point plan. It is important not merely to suppress symptoms in the face of ongoing exposure.
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