Management of work-related asthma: guidelines and challenges

Legiest, Barbara; Nemery, Benoît

doi:10.1183/09059180.00002912

Cited by 13 publications

(12 citation statements)

References 48 publications

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“…(ii) probable, induced by multiple high-level exposures to irritants ; (iii) possible, occurring with a latency period after chronic low-to-moderate level exposures. IIA with latency (low to moderate exposure level) cannot be reliably diagnosed in individual workers 21 and may be clinically indistinguishable from immunological OA and WEA 2,16,22 .…”

Section: Irritant-induced Asthma Among Current Classifications Of Wormentioning

confidence: 99%

“…Non-allergic asthma, mostly characterized by neutrophilic than eosinophilic inflammation, may be more frequent in persistent adult-onset asthma, but remains less well understood 2,14 . In the context of OA, which is considered a good model to study asthma in general, there is a long-lasting debate regarding whether chronic irritant exposures at a low to moderate level may induce asthma 7,[15][16][17] .…”

Section: Introductionmentioning

confidence: 99%

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Do chronic workplace irritant exposures cause asthma?

Dumas

Moual

2016

Current Opinion in Allergy &Amp; Clinical Immunology

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Evidence of a causal effect of chronic workplace irritant exposure in new-onset asthma remains limited, mainly because of a lack of longitudinal studies and the difficulty to evaluate irritant exposures. However, recent epidemiological studies strengthen the evidence of an effect of chronic exposure to irritants in work-related asthma. The underlying mechanism remains unknown but may be related to oxidative stress, neurogenic inflammation and dual irritant and adjuvant effects. However, disentangling chronic irritant effects from either acute irritant-induced asthma or immunological low molecular weight agent-induced asthma is difficult for some agents. Further research is needed to improve assessment of irritant exposures and identify biomarkers.

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Section: Irritant-induced Asthma Among Current Classifications Of Wormentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Do chronic workplace irritant exposures cause asthma?

Dumas

Moual

2016

Current Opinion in Allergy &Amp; Clinical Immunology

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“…WRA is often under-recognized and adults with possible WRA may have undiagnosed WRA. 9,38 Because of this, the true vaccination prevalence among adults with WRA is likely lower than reported, as adults with physician-diagnosed WRA may receive more medical care and may be more likely to receive a pneumococcal vaccine. This study is also subject to several limitations.…”

Section: Discussionmentioning

confidence: 99%

Pneumococcal Vaccination Among Adults With Work-related Asthma

Dodd

Mazurek

2017

American Journal of Preventive Medicine

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Introduction Pneumococcal vaccination is recommended for all adults with asthma and a Healthy People 2020 goal aims to achieve 60% coverage among high-risk adults, including those with asthma. Adults with work-related asthma have more severe asthma symptoms than those with non–work-related asthma and are particularly vulnerable to pneumococcal pneumonia. Methods To assess pneumococcal vaccination coverage by work-related asthma status among ever-employed adults aged 18–64 years with current asthma, data from the 2012–2013 Behavioral Risk Factor Surveillance System Asthma Call-back Survey for ever-employed adults (18–64 years) with current asthma from 29 states were examined in 2016. Adults with work-related asthma had ever been told by a physician their asthma was work-related. Pneumococcal vaccine recipients self-reported having ever received a pneumococcal vaccine. Multivariate logistic regression was used to calculate adjusted prevalence ratios and associated 95% CIs. Results Among an estimated 12 million ever-employed adults with current asthma in 29 states, 42.0% received a pneumococcal vaccine. Adults with work-related asthma were more likely to have received a pneumococcal vaccine than adults with non–work-related asthma (53.7% versus 35.0%, respectively, prevalence ratio=1.24, 95% CI=1.06, 1.45). Among adults with work-related asthma, pneumococcal vaccine coverage was lowest among Hispanics (36.2%) and those without health insurance (38.5%). Conclusions Pneumococcal vaccination coverage among adults with work-related asthma and non–work-related asthma is below the Healthy People 2020 target level. Healthcare providers should verify pneumococcal vaccination status in their patients with asthma and offer the vaccine to those not vaccinated.

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“…A review by Rachiotis et al found that complete symptomatic recovery occurred in one third of people with sensitizer-induced occupational asthma after cessation of exposure to the offending agent [23]. Exposure avoidance results in a higher likelihood of symptom improvement but also a higher likelihood of unemployment and loss of income [24]. The American College of Chest Physicians recommends that individuals with irritant-induced occupational asthma or work-exacerbated asthma reduce exposure to the offending agent [2,25].…”

Section: Discussionmentioning

confidence: 99%

Work-related asthma and employment status – 38 states and District of Columbia, 2006–2009

2013

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Objectives To examine differences in current employment status between persons with health professional-diagnosed work-related asthma and non-work-related asthma and to examine factors associated with unemployment in these groups. Methods We analyzed the 2006–2009 Behavioral Risk Factor Surveillance System Asthma Call-back Survey for ever-employed adults (excluding those who were retired, homemakers and students at the time of the interview) with current asthma in 38 states and District of Columbia (N = 25 680). We calculated prevalence ratios (PRs) adjusted for age, sex, race/ethnicity, education and income. Results Among adults with current asthma, individuals with work-related asthma were less likely to be currently employed for wages (PR = 0.89; 95% confidence interval [CI] = 0.84–0.95) and more likely to be unable to work (PR = 1.44; 95% CI = 1.24–1.67) than those with non-work-related asthma. Among adults with current asthma who were unemployed at the time of the interview, adults with work-related asthma did not differ from those with non-work-related asthma in naming disability as reason for unemployment (PR = 1.09; 95% CI = 0.94–1.26). However, those with work-related asthma were more likely to be unable to work for health reasons other than disability (PR = 1.46; 95% CI = 1.01–2.12) than adults with non-work-related asthma. Conclusions Additional studies are needed to determine what health reasons prevent individuals with work-related asthma from working and if the health reasons are asthma-related.

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Management of work-related asthma: guidelines and challenges

Cited by 13 publications

References 48 publications

Do chronic workplace irritant exposures cause asthma?

Do chronic workplace irritant exposures cause asthma?

Pneumococcal Vaccination Among Adults With Work-related Asthma

Work-related asthma and employment status – 38 states and District of Columbia, 2006–2009

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