Characterization of Occupational Eosinophilic Bronchitis in a Multicenter Cohort of Subjects with Work-Related Asthma Symptoms

Lessons from Occupational Eosinophilic Bronchitis

“…Because, the definitive test for OEB, induced sputum cytology testing, is not widely available, it is likely that this diagnosis is easily missed in clinical practice. Suspicion may be raised from a history of isolated cough with normal pulmonary function and methacholine challenge: the study in this issue 4 indicates that the patients with OEB were more likely to have an isolated cough as their symptom compared both to those with confirmed occupational asthma and those in the study who had challengenegative work-related symptoms (likely including workexacerbated asthma). However, an isolated cough is neither sensitive nor specific, present in only 21% of the patients with OEB, and most also had other symptoms.…”

“…NAEB represents 1 of the top 4 common causes of chronic dry cough. 1,2 In contrast, although there are many occupational causes of chronic cough, 3 an occupational cause for eosinophilic bronchitis has only been recognized on the basis of single case reports before the current report by Wiszniewska et al 4 in the current issue. 4 As the authors review in a supplement to their current article, a total of 13 well-documented subjects have been previously reported.…”

“…1,2 In contrast, although there are many occupational causes of chronic cough, 3 an occupational cause for eosinophilic bronchitis has only been recognized on the basis of single case reports before the current report by Wiszniewska et al 4 in the current issue. 4 As the authors review in a supplement to their current article, a total of 13 well-documented subjects have been previously reported. 4 Thus, there has been no earlier well-documented case series of occupational eosinophilic bronchitis (OEB), and the relative frequency and features of this entity have been unclear.…”

“…4 As the authors review in a supplement to their current article, a total of 13 well-documented subjects have been previously reported. 4 Thus, there has been no earlier well-documented case series of occupational eosinophilic bronchitis (OEB), and the relative frequency and features of this entity have been unclear. The lack of general availability of induced sputum cytology as a diagnostic test has likely contributed to a lack of data on this condition and lack of recognition of it.…”

“…The mean time away from the last exposure to the work sensitizer before the specific challenge in this cohort was 6 months, and only 30% of those with confirmed OEB had a prechallenge sputum eosinophil count of more than 3%. 4 This illustrates that, analogous to airway responsiveness tests for occupational asthma, the test for sputum eosinophils should be performed shortly after exposure to the work sensitizer with repeat for comparison away from exposure.…”