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Published in Ken Addley, MCQs, MEQs and OSPEs in Occupational Medicine, 2023
Respiratory sensitisation and occupational asthma. Occupational asthma symptoms may include wheeze, cough, shortness of breath and chest tightness as well as upper respiratory symptoms such as rhinitis and eye itching. Isocyanates are also very irritant, and exposure can also result in hypersensitivity pneumonitis.
Allergic Responses to Powdered Natural Rubber Latex Gloves in Healthcare Workers
Published in Robert N. Phalen, Howard I. Maibach, Protective Gloves for Occupational Use, 2023
A diagnostic algorithm for the diagnosis of occupational asthma has been proposed. In HCWs with work-related asthma symptoms, the first step is the assessment of non-specific bronchial hyperresponsiveness and the immunological sensitization (via skin prick tests or measurement of specific IgE). In patients with negative or weakly positive test results, serial measurements of PEF, sputum eosinophils at/off work, and specific inhalation challenges may be performed to confirm the diagnosis.32
Occupational Asthma
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Bill Brashier, Amruta Wankhede
Occupational asthma is a “disease characterized by variable airway obstruction and/or airway hyperresponsiveness due to causes or conditions attributable to a particular occupational environment and not to stimuli encountered outside the workplace” (Greiwe and Bernstein 2019, Friedman-Jimenez et al. 2015, Balogun et al. 2018).
Methyl methacrylate and respiratory sensitisation: a comprehensive review
Published in Critical Reviews in Toxicology, 2022
Occupational asthma is an important problem that gives rise to health, social, and economic burdens (Kenyon et al. 2012; Feary et al. 2016; Tiotiu et al. 2020). It is frequently defined as a function of symptoms associated with exposures in the workplace environment, rather than in terms of the pathogenic processes through which the disease develops. In fact, occupational asthma is associated with two broad classes of mechanism. One is allergic asthma which is driven by allergic sensitisation of the respiratory tract and therefore, by definition, requires the stimulation of a specific immune response. The second is non-allergic asthma, acquired as a result of non-immunological mechanisms. The latter can take a variety of forms but is frequently associated with local irritation (Vandenplas 2011; Tarlo and Lemiere 2014; Arts and Kimber 2017; Maestrelli et al. 2020).
Identifying a reference list of respiratory sensitizers for the evaluation of novel approaches to study respiratory sensitization
Published in Critical Reviews in Toxicology, 2021
Nikaeta Sadekar, Fanny Boisleve, Wolfgang Dekant, Allison D. Fryer, G. Frank Gerberick, Peter Griem, Christina Hickey, Nora L. Krutz, Olga Lemke, Cecile Mignatelli, Reynold Panettieri, Kent E. Pinkerton, Kevin J. Renskers, Paul Sterchele, Simone Switalla, Matthew Wolter, Anne Marie Api
In this review, much of the literature poorly supported the occupational cases of respiratory sensitization from PA exposures. Chester et al. (1977) summarized findings in a single subject case report. However, when compared to the other published reports, more information is required to establish if the subject was hyper-susceptible to PA-based respiratory sensitization. There are detailed observations of occupational asthma supported with either a re-challenge test, cessation of symptoms upon withdrawal from the workstation, or confirmation from a skin test or specific serum antibody testing. It was noted that the subjects commonly experienced respiratory irritation and immediate-type respiratory sensitization; however, the medical histories or possible cross-reactivity from other anhydrides further complicate these reports (Kern 1939; Chester et al. 1977; Wernfors et al. 1986; Baur et al. 1995; Piirila, Keskinen, et al. 1997). Thus, there is very low confidence in PA for use as a positive control in developing scientific research for respiratory sensitization.
Work-related asthma in cobalt-exposed workers
Published in Journal of Asthma, 2021
A. Al-abcha, L. Wang, M. J. Reilly, K. D. Rosenman
Among the 35 individuals reported, the median duration of symptoms before the diagnosis of work-related asthma was one and a half years, and the median duration of continued exposure to cobalt after a diagnosis of WRA was one year (Table 2). The duration of symptoms before the diagnosis was as long as 24 years and the duration of exposure after the diagnosis of WRA was as long as 27 years (Table 2). Other studies have reported an average delay of 3.2 to 4.9 years to the diagnosis of occupational asthma (7,25). Consensus statements and studies have attributed 10–55% of new-onset asthma to occupational exposures (11,24–26). Cobalt has been associated with occupational asthma with prevalence rates of 5–15% in workforces exposed to cobalt (8,9). A study of workers exposed to cobalt in a cobalt smelting plant, found a 5-fold increased risk of asthma in workers when compared to non-exposed workers (27). Despite evidence regarding the risks of occupational exposures as a contributor to the incidence of new-onset asthma, delay in diagnosis continues to occur. The sooner an individual is diagnosed with work-related asthma and removed from the exposure, the better the prognosis for that individual to either improve or have total remission of their asthma symptoms (15,28).