Primary prevention: exposure reduction, skin exposure and respiratory protection

Abstract

Interventions for the primary prevention of occupational asthma have been reported in the medical literature, understanding the effectiveness of these efforts could help future interventions. The aim of our study was to evaluate the existing knowledge regarding the impact of controlling work exposure on the prevention of occupational asthma. We conducted systematic literature searches through April 2010 to examine if control of workplace exposures is effective for primary prevention of sensitisation and occupational asthma. The literature search for primary prevention of occupational asthma yielded 29 studies. Assessment of the available information led to the following conclusions and recommendations concerning primary prevention of occupational asthma. Exposure elimination is the strongest and preferred primary preventive approach to reduce the burden of occupational asthma. If elimination is not possible, exposure reduction is the second best option for primary prevention of occupational asthma. The evidence for the effectiveness of respirators in preventing occupational asthma is limited, and other options higher in the list of controls for occupational exposures, notably eliminating or minimising exposures at the source or in the environment, should be used preferentially. There is strong evidence to recommend not using powdered allergen-rich natural rubber latex gloves. There is weak evidence that suggests workers should minimise skin exposure to asthma-inducing agents.

Guidelines for the management of work-related asthma

“…There was no statistically significant difference between respirators, but none of the workers who wore the fullface respirators developed occupational asthma, even those who worked in high-exposure jobs. More detailed comments to individual statements are provided by HEEDERIK et al [161].…”

ERS publications: the flagship and the fleet

“…The June 2012 issue contained a series of articles written by members of an ERS task force on the management of workrelated asthma [11][12][13][14][15], which provided vital background and context to the main summary document, published in the ERJ [16]. The success of this joint venture will hopefully act as a model for future task forces.…”

Management of work-related asthma: guidelines and challenges

“…Animal studies have demonstrated that dermal exposure to sensitisers can elicit respiratory inflammation after airway challenge [30]. Case reports and limited epidemiological studies (primarily isocyanates) support this concept [31]. Moreover, several common occupational contact allergens can also potentially cause occupational asthma [32].…”