Chest
Clinical InvestigationsOutcome of Assessments for Occupational Asthma
Section snippets
MATERIALS AND METHODS
A retrospective review was performed on the files of 154 consecutive workers referred for assessment of possible occupational asthma. They were all seen in the clinics of the Gage Research Institute (35 workers) and the Toronto General Hospital (119 workers) between 1978 and 1987 by a single clinician, using the same diagnostic approach throughout.
All patients had symptoms thought by their referring doctor to be consistent with intermittent airflow limitation or bronchial hyperresponsiveness
Diagnostic Groups and Characteristics
Sixty-one of the 154 patients were finally diagnosed as having occupational asthma (Table 1), including 51 whose asthma was attributed to a workplace sensitizer and ten whose asthma was attributed to an irritant. In 45 other patients, a diagnosis of possible occupational asthma was reached, in 29 related to a sensitizer and in 16 related to an irritant exposure. In these patients, the findings were suggestive of occupational asthma, but objective tests were either inconclusive or could not be
DISCUSSION
This population showed a significant increase in atopic patients among those with a positive diagnosis of occupational asthma due to a specific sensitizer (Table 3) as has been reported in occupational asthma due to high-molecular-weight allergens.9, 10, 11 A minority of sensitizer-induced occupational asthma patients, 19 out of 51 (37 percent), had exposure and positive specific skin tests to a high-molecular-weight workplace allergen, but these accounted for most of the increase in atopy (84
ACKNOWLEDGMENTS
The authors wish to acknowledge the secretarial assistance of Peggy Murawnik, Beryl Gibson, and L. O'Connor in preparation of this manuscript.
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Trends in Occupations and Work Sectors Among Patients With Work-Related Asthma at a Canadian Tertiary Care Clinic
2016, ChestCitation Excerpt :Statistics Canada indicates that workers aged 55 years or older accounted for 18.7% of total employment in 2011 compared with 15.5% in 2006.24 Although bakers’ asthma was the second most common cause of OA during the earlier period of this review, similar to our previous findings and reports from other areas,18,25,26 in more recent years a relative increase has been seen in the proportion of patients with WRA from health-care and education sectors. From 2000 through 2007 and 2008 through 2015, cases related to the health-care sector increased from 4% of total cases to 10% of total cases.
Diagnosis and management of work-related asthma: American College of Chest Physicians consensus statement
2008, ChestCitation Excerpt :They are effort dependent and require good cooperation from the individual being investigated. PEFRs may be incomplete or uninterpretable for a variety of reasons.105,106 Individuals may not be able to use the peak flowmeter or have difficulty in making PEFRs regularly over a prolonged period, despite training.
Occupational Exposures and Adult Asthma
2008, Immunology and Allergy Clinics of North AmericaCitation Excerpt :Even within tertiary referral clinics, a proportion of patients referred for assessment of suspected work-related asthma does not have asthma but has other causes of work-related symptoms, such as vocal cord dysfunction, upper airway cough syndrome, or gastroesophageal reflux. In one tertiary referral clinic, 31% of those referred for assessment of possible OA had no objective evidence of asthma although still working with the implicated occupational exposure [14]. In addition, the first onset of asthma during a working period, despite being a typical characteristic of patients who have OA, is not specific, because the proportion of all adult asthma attributable to occupation is estimated at 5% to 19%, median 9% [15], implying that a majority of adult asthma begins coincidental to work exposures.
Pulmonary function testing in work-related asthma: An overview from spirometry to specific inhalation challenge
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Manuscript received June 18; revision accepted Decensber 10.