Chest
Occupational and Environmental Lung DiseaseOccupational Asthma: A Longitudinal Study on the Clinical and Socioeconomic Outcome After Diagnosis
Section snippets
Study Design
Subjects were examined at the time of diagnosis of OA and reevaluated at 1, 3, 6, and 12 months after diagnosis. Allergy skin tests were performed at time of diagnosis. For the duration of the study, all patients reported peak expiratory flow (PEF) values on a personal asthma diary together with symptoms, drug intake, medical events, and disease-related costs (see below). At time of diagnosis and at each following visit, clinical examination, spirometry, and bronchial challenge with
Results
Three subjects refused to be enrolled in the study while four others did not come to control visits (two preferred to be followed up in another center, while two were no longer interested in participating in the study). The remaining 25 subjects completed the study. Among participants, OA was due to high-molecular-weight (HMW) agents in 3 subjects and to low-molecular-weight (LMW) agents in 22 (isocyanates in 9 of them) (Table 1). In the seven nonparticipants, the causal agents were LMW agents.
Discussion
In this prospective study, we followed up a group of subjects with OA due to various agents at regular intervals of time for 1 year after the diagnosis, recording at each time point their clinical, functional, employment, and financial status.
Removal from exposure to the offending agent is recommended as the first-line measure for the management of OA.3, 4 Our data show that in Italy7 as in other countries5, 8 where this procedure is not mandatory, this occurs only in a limited proportion of
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Cited by (87)
Occupational asthma caused by high- and low-molecular weight agents in an auto body worker
2018, Annals of Allergy, Asthma and ImmunologyUnderstanding health beliefs and behaviour in workers with suspected occupational asthma
2015, Respiratory MedicineEvolution of occupational asthma: Does cessation of exposure really improve prognosis?
2014, Respiratory MedicineCitation Excerpt :Occupational asthma (OA) is the most frequent work-related respiratory disease in developed countries [1,2] and it is estimated that roughly 10% cases of bronchial asthma and between 15 and 25% of adult onset asthma may be of occupational origin [3,4].
Work-Related Asthma: A Case-Based Approach to Management
2011, Immunology and Allergy Clinics of North AmericaCitation Excerpt :One study showed that factors keeping workers in their jobs include higher education level and income, age older than 40 years, longer years with the current employer, children to support, and exposure to an HMW agent (vs a low-molecular-weight [LMW] agent).14 Asthma severity did not predict moving out of exposure or job in this review, although others have suggested this.15 The medical literature is inconsistent regarding the long-term outcomes of continued but reduced exposure to HMW allergens in workers with HMW OA compared with LMW OA, in which continued exposure usually leads to worsened disease.
Occupational agents
2009, Asthma and COPDCosts of occupational asthma in the UK
2011, Thorax
Supported by grant ICS-57.3/RF92/719, from the Italian Ministry of Health.