Progress in Occupational Asthma

Abstract

Occupational asthma (OA) represents one of the major public health problems due to its high prevalence, important social and economic burden. The aim of this review is to summarize current data about clinical phenotypes, biomarkers, diagnosis and management of OA, a subtype of work-related asthma. Most studies have identified two phenotypes of OA. One is sensitizer-induced asthma, occuring after a latency period and caused by hypersensitivity to high- or low-molecular weight agents. The other is irritant-induced asthma, which can occur after one or more exposures to high concentrations of irritants without latency period. More than 400 agents causing OA have been identified and its list is growing fast. The best diagnostic approach for OA is a combination of clinical history and objective tests. An important tool is a specific inhalation challenge. Additional tests include assessments of bronchial hyperresponsiveness to methacholine/histamine in patients without airflow limitations, monitoring peak expiratory flow at- and off-work, sputum eosinophil count, exhaled nitric oxide measurement, skin prick tests with occupational allergens and serum specific IgE. Treatment of OA implies avoidance of exposure, pharmacotherapy and education. OA is a heterogeneous disease. Mechanisms of its different phenotypes, their diagnosis, role of new biomarkers and treatment require further investigation.

Occupational Exposures to Organic Solvents and Asthma Symptoms in the CONSTANCES Cohort

“…These results are consistent with those from Torén et al and Le gested that solvents were associated with adult-onset asthma [23 also consistent with a few studies on trichloroethylene and paints gested an association between these chemicals and asthma or respi ciations between inks, which contained acrylates, and adult-onset a reported [39]. Associations between formaldehyde, a known asthm comes were not entirely consistent in our analyses, in particular in formaldehyde is now classified as a human carcinogen by the Int Research on Cancer (IARC) [40], its use has probably declined sinc our knowledge, occupational exposures to gasoline, cellulosic thi have never been studied in relation to asthma or respiratory disea first to show significant associations between several specific solv 1.0 * Exposure to at least one solvent: gasoline, trichloroethylene, white spirit, cellulosic thinner, forma paints/varnishes or inks/dyes.…”

“…Our findings are also consistent with a few studies on trichloroethylene and paints [16,25,38], which suggested an association between these chemicals and asthma or respiratory diseases. Associations between inks, which contained acrylates, and adult-onset asthma have also been reported [39]. Associations between formaldehyde, a known asthmagen, and asthma outcomes were not entirely consistent in our analyses, in particular in women.…”

“…Although these different estimates are not directly comparable (mean score ratios vs. odds ratios), we observed more significant associations between lifetime exposures to solvents and the asthma symptom score than with current asthma, notably when exposures were assessed with the JEM. This disparity could be explained by an under-recognition of work-related asthma [39]. Occupational exposure to solvents may also be associated with a specific asthma phenotype (e.g., irritant-induced asthma), which may not commonly be recognized as asthma [44].…”

Molecular Insights of Nickel Binding to Therapeutic Antibodies as a Possible New Antibody Superantigen

“…Ni IgE-mediated hypersensitivity occurs most commonly as occupational hazards ( 24 ), where the prolonged exposures elicited Ni-interacting IgEs ( 25 ) through possible “non-antigenic” mechanisms ( 26 ) that arise from the expansion of existing IgEs (capable of additionally binding Ni) producing B-cells. We hypothesize the Ni-only specific IgEs to be extremely rare given the chemical nature of Ni, but rather that the unintended non-specific binding to Ni during antibody repertoire generation to other antigens occurred and were gradually selected for and expanded.…”

Presumed Exposure to Chemical Pollutants and Experienced Health Impacts among Warehouse Workers at Logistics Companies: A Cross-Sectional Survey

“…Due to the relatively young study population, chronic health problems can be in the preclinical phase and remain undiagnosed for long, manifesting only in old age when a causal relationship is difficult to establish. Dry cough and numbness or heaviness in the arms or legs could be associated with work in closed spaces of transportation and storage, representing respiratory irritation and peripheral neurotoxic effects, which are symptoms potentially induced by chemical exposures to fumigants and various solvents [ 28 , 29 , 30 ]. Although no significant correlation was found, trembling of hands, muscle cramps, slurred speech, and unpleasant taste in the mouth were more frequent among warehouse workers.…”