Work-related asthma includes two subtypes: occupational asthma or asthma caused by specific agents (sensitisers or irritants) in the workplace, and work-exacerbated asthma or pre-existing asthma worsened by workplace exposures. This review provides an update on the definitions and the clinical features of the different work-related asthma subtypes as well as new insights into their aetiology and the pathophysiological mechanisms involved. The diagnosis of work-related asthma should be made on objective basis using a constellation of clinical, physiologic and allergologic tests. Specific inhalation challenge with the suspected occupational agent(s) remains as the reference standard for diagnosis. A literature search was performed using the following terms: work-related asthma, occupational asthma, work-exacerbated asthma, irritant-induced asthma and etiological agents. Studies focusing on the biological effects and mechanisms of environmental exposures in the development of sensitiser-induced or irritant-induced asthma in various workplace settings are of greatest interest. An integrative approach that combines clinical parameters with component-resolved diagnosis as well as inflammatory biomarkers appears to be very promising. Occupational allergy provides a good opportunity to understand the complex relationships between exposure to allergens in the workplace, interaction with genes and the co-exposures to other factors in the working environment.
Authors: Quirce S, Campo P, Domínguez-Ortega J, Fernández-Nieto M, Gómez-Torrijos E, Martínez-Arcediano A, Mur P, Delgado J. ;Full Source: Expert Review of Clinical Immunology. 2016 Sep 21. [Epub ahead of print] ;