The prevention of occupational asthma

Abstract

There is sufficient understanding of the causation of occupational asthma for preventive action to be appropriate. To date, attempts appear to have been largely unsuccessful and this appears to be largely due to nonscientific/technical obstacles. These include the fragmented nature of the disease, its low public and industrial profile, and its comparative rarity in single workplaces. Nonetheless the disease has high individual and societal costs.Prevention strategies should be concentrated on workplace-exposure controls, accompanied by intense educational and managerial improvements. Methods of secondary prevention appear to be successful but require considerable refinement. Screening (out) of potential new employees is inefficient and likely to remain so; and in any case is beset by difficult ethical and legal issues.There are only a handful of published studies reporting evaluations of preventive programmes. None is entirely rigorous but each suggests that primary and secondary prevention are both feasible and highly effective. The evaluation of preventive strategies is difficult, not only because of the low incidence of the disease in individual workplaces but also because of the failure of many epidemiologists to engage in this work. Considerably more cooperation between scientists in the field, regulatory authorities and industry is required.

Guidelines for the management of work-related asthma

“…This is because they are far too weakly associated with the development of workrelated asthma, symptoms or other signs of work-related asthma (*) [143][144][145]. 9) Early detection of work-related respiratory symptoms, sensitisation and work-related asthma is possible using medical surveillance, which includes a questionnaire in combination with at least one of the following options: detection of specific sensitisation, NSBHR testing, SIC, diagnostic work up in a referral centre (**) [57,123,[147][148][149][150][151][152][153].…”

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…However, the reduction in allergens may not be sufficient and studies in latex allergy are usually of a small size or are hampered by methodological issues preventing a strong recommendation (137,1435). An early diagnosis of the disease is needed for the tertiary prevention of OADs since the earlier the worker is removed from the workplace, the more likely he/she will be cured (1436). Moreover, after some years of exposure, intractable asthma may persist even after work cessation.…”

“…Very few surveillance programs have been carried out to assess the efficacy and effectiveness of primary prevention (1436,1858) and some are subject to criticism. In workers exposed to enzymes, preventive measures have been found to reduce the onset of asthma (1859)(1860)(1861).…”

Untersuchungsmethoden für die Arbeitsmedizinische Vorsorge bei Platinsalzexposition – eine exploratorische Datenanalyse

“…Während für die Primärprävention weitestgehend die Reduktion von Expositionsgefahren in Frage kommt (Cullinan et al, 2003;, ist es in der Sekundärprävention wichtig, Berufsasthma rechtzeitig zu diagnostizieren, um Maßnahmen zu treffen, die die Progredienz der Erkrankung begrenzen. Bei der Entwicklung einer Platinsalz-Allergie werden betroffene Arbeiter aus einem möglichen Expositionsbereich versetzt (Merget et al, 2001;.…”