PT  - JOURNAL ARTICLE
AU  - Paul Henneberger
AU  - Kjell Torén
TI  - Causes of work-exacerbated asthma
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P1017
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P1017.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P1017.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - RATIONALE. A 2011 Statement of the American Thoracic Society concluded that work-exacerbated asthma (WEA) is common in industrialized nations, with a prevalence of 21.5% in adults with asthma. While there are published lists of workplace agents that can cause occupational asthma, there are no comparable lists for WEA. We reviewed published articles to prepare such a list.METHODS. We systematically searched the peer-reviewed medical literature to identify articles about WEA published during 1980–2011. We selected articles that reported WEA agents determined case-by-case (from clinical case series, surveillance and worker compensation programs) or in risk-set analyses that used statistical models to determine occupational exposures associated with exacerbation of asthma or WEA.RESULTS. The literature search identified 13 articles that reported exposures for work-related exacerbation of asthma, including 3 risk-set studies. The studies were conducted in several countries in North America and Europe, and used various criteria for WEA and methods to determine exposures. From studies with WEA identified on a case-by-case basis, the more common types of agents included miscellaneous chemicals, dust, paint, smoke, indoor air quality, and cleaning products. From two risk-set studies conducted in general population settings, exposures with statistically significant (p≤0.05) relative risks of 2.0 or greater included dusts, high exposure to gas and fumes, indoor air quality, physically strenuous work, and probable daily occupational exposure to dust, gases, or fumes.CONCLUSIONS. Various types of workplace exposures can exacerbate asthma, including irritants, agents with sensitizing traits, and physical factors such as strenuous exercise.