Distribution of Sensitizer-Induced Occupational Asthma

Abstract

Introduction: Occupational asthma (OA) became an important public health problem worldwide in the last few decades. From two different OA types, sensitizer-induced OA accounts for approximately 90% of all OA cases. Aim of the study was to present the distribution of sensitizer-induced OA by occupation in R. Macedonia in the period 2005-2014.Methods: Sensitizer-induced OA was diagnosed by serial measurement of peak expiratory flow (PEF) at and away from work or by combination of serial PEF measurement at and away from work and non-specific bronchial provocation at and away from work in subjects with diagnosed asthma and work-relatedness of the symptoms. Results:The annual incidence rate of the diagnosed sensitizer-induced OA in the mentioned period varied from 1.8/100,000 working population in 2013 to 2.8/100,000 in 2006. Sensitizer-induced OA in bakers, cleaners, textile workers and agricultural workers accounted up to more than a third of the all diagnosed cases. Atopy was registered in approximately a half of the sensitized-induced OA cases. Majority of the cases with sensitizer-induced OA caused by HMW agents (i.e. OA in bakers, textile workers, tanners, herbal and fruit tea processors, and health care workers) was atopics and had positive prick tests to occupational allergens. sensitizer-induced and irritant-induced OA. Sensitizer-induced OA, which accounts for approximately 90% of all OA cases, is characterized by a latency period between first exposure to a respiratory sensitizer at work and the first presentation of symptoms, while irritantinduced OA starts typically within a few hours of a high-intensity exposure to an irritant gas, fumes or vapor encountered at work [3]. More than 250 occupational sensitizers causing OA have been described. According to their molecular weight these occupational agents are categorized into high-molecular-weight (HMW) agents (e.g. animal and plant proteins, flour and grain dust, latex, etc.) and low-molecular-weight (LMW) reactive chemicals (e.g. isocyanates, colophony, aldehydes, metal salts, etc.) Sensitization to most HMW and some LMW agents is through an immunoglobuline E (IgE) mechanisms and can be tested by skin tests, while most LMW agents cause allergic sensitization through IgE-independent mechanisms and an allergen-specific immune response can not be documented by skin tests [7]. ConclusionA recent meat-analysis indicates that occupational factors account for approximately one in six cases of asthma in adults of working age [8]. The incidence of OA within the workforce depends on people's jobs and the workplace hazards to which they are exposed. The aim