EDITORIAL

Exposure assessment should be integrated in studies on the prevention and management of occupational asthma

Dick Heederik¹, Frits van Rooy^1,2

¹ Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, University Utrecht, The Netherlands
² Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, The Netherlands

Correspondence to:
Dr D Heederik, Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, University Utrecht, PO Box 80198, 3508 TD, The Netherlands; d.j.j.heederik@uu.nl

The first 150 words of the full text of this article appear below.

Evidence-based medicine (EBM) approaches have recently been applied to occupational asthma.^{1 2} The EBM document by Newman Taylor et al¹ for occupational asthma evaluates, among other issues, the existence of exposure-response relations for sensitisation and asthma. The cited references indeed provide evidence that exposure-response curves exist for certain high molecular weight allergens. The risk for allergen-specific sensitisation and asthma increases steeply with increasing allergen exposure, especially in atopics.³ More sensitised individuals express respiratory symptoms at higher exposure than at low exposure.⁴ The time to development of allergy is shorter at higher exposures than at lower exposure.⁵

The question arises of what the implications of all these findings are with regard to primary prevention of allergic respiratory disease? Exposure-response relations suggest that lowering the exposure will reduce the burden of disease. Some direct evidence exists which illustrates that reduction of exposure leads to reduction of disease burden. Reduction of the exposure, by . . . [Full text of this article]

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