Authors: Singh TS, Mabe O
Source: Occupational Health Southern Africa 2008; 14(3), 12-19
Asthma is a heterogeneous disease and within its spectrum there are several phenotypes and sub-phenotypes that are important for both clinical evaluation and management. The disease may further be complicated by workplace exposures resulting in a number of conditions under the umbrella term work-related asthma. Understanding and making the distinction between the various forms of work-related asthma is pertinent for the prognosis and obtaining adequate compensation of the affected worker.
A systematic review of relevant publications from 1998 to 2008 on the topic work-related asthma and occupational asthma was conducted.
This article focuses on the issue that work-related asthma is not a homogenous disease, but in fact can be caused by various exposures most notably allergens and irritants which may cause reversible airflow obstruction with different underlying inflammatory responses. It outlines current concepts and provides a range of examples of high risk occupational environments and exposures typically associated with different phenotypes of asthma. It also aims to promote some understanding of the main inflammatory mechanisms involved in allergen and irritant induced work-related asthma.
Understanding the phenotypic and pathophysiologic characteristics of work-related asthma may alleviate some of the constraints regarding the diagnosis and management of work-related asthma which may account for up to one third of adult asthma cases.