Occupational asthma - Practical points for diagnosis and management

Asthma is a common chronic illness characterized by episodes of reversible airflow obstruction. A cornerstone of asthma management is identifying and avoiding agents that cause bronchospasm. The workplace is an important pote ntial source of respirable exposures that can cause or trigger asthma. Iden tification of an occupational factor in asthma is important: early diagnosi s and removal of the worker from the exposure is associated with improved p rognosis; the diagnosis of occupational asthma may lead to compensation for work-related impairment and disability; and the diagnosis of occupational asthma is a Sentinel Health Event with implications for public health and p revention. In this article, we review specific causes of occupational asthm a and general settings in which an occupational factor should be suspected and explored as part of the management of the worker with asthma. We also r eview specific and simple elements of history and pulmonary function testin g that can be easily assessed by most health care practitioners and may be sufficient to establish a diagnosis of occupational asthma. Finally, we rev iew the medical-legal implications of occupational asthma.