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Occupational asthma: Definitions, epidemiology, causes, and risk factors
| AuthorsMoira Chan-Yeung, MDJean-Luc Malo, MD | Section EditorPeter J Barnes, DM, DSc, FRCP, FRS | Deputy EditorHelen Hollingsworth, MD |
Topic Outline
GRAPHICS
INTRODUCTION
Occupational asthma (OA) is a form of work-related asthma characterized by variable airflow obstruction, airway hyperresponsiveness, and airway inflammation attributable to a particular exposure in the workplace and not due to stimuli encountered outside the workplace [1,2].
Occupational asthma accounts for approximately 10 to 25 percent of adult onset asthma [3,4]. A high degree of clinical suspicion is needed as the latency period for sensitization varies from a few months to several years, depending on several factors, including the intensity of exposure, the specific sensitizing agent, and individual susceptibility.
The definition, epidemiology, causes, and risk factors of OA are reviewed here. The pathophysiology, clinical assessment, diagnosis, and management of OA are discussed separately. (See "Occupational asthma: Pathogenesis" and "Occupational asthma: Clinical features and diagnosis".)
DEFINITIONS
Several terms are used to define the various forms of work-related asthma [5]:
- Occupational asthma (OA) begins during adulthood and is induced by exposure to immunologic or non-immunologic stimuli found in the workplace [3].
- Work-exacerbated asthma (also known as work-aggravated asthma) is defined as preexisting or concurrent asthma that subjectively worsens in the workplace [6]. (See "Diagnosis of asthma in adolescents and adults".)
- Irritant-induced asthma results from single or multiple exposures to a nonimmunologic, irritant substance at a high level of intensity. When workplace exposure(s) cause irritant-induced asthma, it is considered a subset of occupational asthma. However, the airway histopathology is different from immunologic OA (table 1). (See "Reactive airways dysfunction syndrome and irritant-induced asthma".)
- Reactive airways dysfunction syndrome (RADS) is a form of irritant-induced asthma that is triggered by a single acute high level exposure to a nonimmunologic stimulus [7]. Symptoms begin within minutes of the exposure, and the initial symptoms are followed by on-going asthma-like symptoms and bronchial hyperresponsiveness that last for a prolonged period. (See "Reactive airways dysfunction syndrome and irritant-induced asthma", section on 'Definitions'.)
- Occupational nonasthmatic eosinophilic bronchitis is an asthma variant that develops in the workplace and causes symptoms that mimic asthma, but is not associated with bronchial hyperresponsiveness. (See "Evaluation of subacute and chronic cough in adults", section on 'Nonasthmatic eosinophilic bronchitis'.)
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Literature review current through:
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