PT  - JOURNAL ARTICLE
AU  - X. Baur
AU  - T. Sigsgaard
AU  - T.B. Aasen
AU  - P.S. Burge
AU  - D. Heederik
AU  - P. Henneberger
AU  - P. Maestrelli
AU  - J. Rooyackers
AU  - V. Schlünssen
AU  - O. Vandenplas
AU  - D. Wilken
TI  - Guidelines for the management of work-related asthma
AID  - 10.1183/09031936.00096111
DP  - 2012 Mar 01
TA  - European Respiratory Journal
PG  - 529--545
VI  - 39
IP  - 3
4099  - http://erj.ersjournals.com/content/39/3/529.short
4100  - http://erj.ersjournals.com/content/39/3/529.full
SO  - Eur Respir J2012 Mar 01; 39
AB  - Work-related asthma, which includes occupational asthma and work-aggravated asthma, has become one of the most prevalent occupational lung diseases. These guidelines aim to upgrade occupational health standards, contribute importantly to transnational legal harmonisation and reduce the high socio-economic burden caused by this disorder. A systematic literature search related to five key questions was performed: diagnostics; risk factors; outcome of management options; medical screening and surveillance; controlling exposure for primary prevention. Each of the 1,329 retrieved papers was reviewed by two experts, followed by Scottish Intercollegiate Guidelines Network grading, and formulation of statements graded according to the Royal College of General Practitioners’ three-star system. Recommendations were made on the basis of the evidence-based statements, which comprise the following major evidence-based strategic points. 1) A comprehensive diagnostic approach considering the individual specific aspects is recommended. 2) Early recognition and diagnosis is necessary for timely and appropriate preventative measures. 3) A stratified medical screening strategy and surveillance programme should be applied to at-risk workers. 4) Whenever possible, removing exposure to the causative agent should be achieved, as it leads to the best health outcome. If this is not possible, reduction is the second best option, whereas respirators are of limited value. 5) Exposure elimination should be the preferred primary prevention approach.