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Recognition and surveillance of occupational asthma: a preventable illness with missed opportunities

Lookup NU author(s): Emeritus Professor David Hendrick

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Abstract

Always consider the possibility of an occupational cause at the time adult-onset asthma is first recognized-the probability of this is of the order 9-15%. Do not prescribe treatment unless this possibility is remote or the asthma is life-threatening. If the possibility is not remote seek immediate advice from a specialized centre, without prescribing masking medication and without curtailing usual work practice. The specialized referral centre should place the accurate measurement of airway responsiveness at the centre of investigatory strategies. A return-to-work study, monitored by serial measurements of airway responsiveness and ventilatory function, provides adequate objective evidence for diagnosis in most cases. When a novel cause is suspected, specific inhalation provocation testing with the particular agent in the specialized centre is desirable. Regular competent surveillance is necessary in high-risk occupational environments; this should include environmental monitoring, the detection of relevant new symptoms, spirometry measurements, serum antibody studies (where available) and a robust protocol for managing inevitable failed attendances.

Publication metadata

Author(s): Hendrick DJ

Publication type: Article

Publication status: Published

Journal: British Medical Bulletin

Year: 2010

Volume: 95

Issue: 1

Pages: 175-192

Print publication date: 01/09/2010

ISSN (print): 0007-1420

ISSN (electronic): 1471-8391

Publisher: Oxford University Press

URL: http://dx.doi.org/10.1093/bmb/ldq021

DOI: 10.1093/bmb/ldq021

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