Occupational asthma: Pathogenesis
- David I Bernstein, MD
David I Bernstein, MD
- Professor of Clinical Medicine and Environmental Health
- University of Cincinnati College of Medicine
- Louis-Philippe Boulet, MD
Louis-Philippe Boulet, MD
- Professor of Medicine
- Laval University
- André Cartier, MD
André Cartier, MD
- Clinical Professor of Medicine
- University of Montreal Medical School, Canada
The label "asthma in the workplace" encompasses several entities: (1) asthma exacerbated at work by various environmental conditions; (2) occupational asthma; and (3) variants (eg, eosinophilic bronchitis) . Occupational asthma is a disease characterized by variable airflow limitation, airway hyperresponsiveness, and inflammation resulting from an inciting agent only found in the workplace .
The pathogenesis and pathology of occupational asthma will be reviewed here. Issues related to other aspects of occupational asthma are discussed separately. (See "Occupational asthma: Definitions, epidemiology, causes, and risk factors" and "Occupational asthma: Clinical features and diagnosis" and "Reactive airways dysfunction syndrome and irritant-induced asthma".)
Two main types of occupational asthma have been recognized [1,3]:
●Immunologically mediated. This type includes IgE and nonIgE-mediated responses following chronic exposure to high or low molecular weight agents.
●Nonimmunologic, irritant-mediated, also called irritant-induced asthma. This type includes reactive airways dysfunction syndrome (RADS) caused by a single high level exposure to an irritant, irritant-induced asthma caused by multiple high level exposures to an irritant, and possibly asthma caused by chronic lower level of exposure, although the latter is controversial. (See "Reactive airways dysfunction syndrome and irritant-induced asthma".)
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