Figure 2 - available via license: CC BY
Content may be subject to copyright.
Diagnostic tests in occupational asthma.
Source publication
Occupational asthma (OA) represents one of the major public health problems due to its high prevalence, important social and economic burden. The aim of this review is to summarize current data about clinical phenotypes, biomarkers, diagnosis and management of OA, a subtype of work-related asthma. Most studies have identified two phenotypes of OA....
Context in source publication
Context 1
... the differential diagnosis, it is important to consider other conditions that can mimics asthma symptoms following exposure to irritants in the workplace such as vocal cord dysfunction, hyperventilation syndrome and mass psychogenic illnesses [3,5]. Figure 2 summarizes the possible tests to use in practice for the confirmation of OA diagnosis. ...
Citations
... Although the age at which asthma develops can vary, it is commonly observed in young adults, who are part of the labor-productive population. In this context, when directly linked to work-related activities, it can be considered an occupational health issue [5,6]. Occupational asthma can be triggered by exposure to various factors in the workplace, such as chemical and biological agents that 2 act as sensitizing and irritating substances [7]. ...
... Furthermore, it is important to note that different studies have found that asthma is more prevalent in urban areas of regions with a higher population density and consequent exposure to environmental pollution [6,19]. In our study, Guayas and Pichincha were the two most populous and industrialized provinces in the country, especially in the city of Guayaquil (Guayas). ...
... The Azuay and Guayas provinces have the largest number of enterprises in the industrial sector. It has been widely demonstrated that workers exposed to chemical agents have a higher prevalence and risk of developing occupational asthma induced by both sensitizers and irritants [6,7]. Additionally, agro-industrial activities predominated in the provinces of El Oro and Los Ríos (in addition to Guayas). ...
Asthma is a significant public health concern. This study identified the provinces with the highest morbidity and mortality rates due to asthma among the working-age population (15-69 years) in the Republic of Ecuador. The secondary objective was to explain the possible differences attribut-able to occupational exposure. This nationwide ecological and exploratory study was conducted in 24 provinces between 2016 and 2019. Government databases were used as sources of infor-mation. Standardized rates were calculated for codes the J45 and J46. The hospitalization mor-bidity rate for asthma decreased from 6.51 to 5.76 cases per 100,000 working-age population, and the mortality rate has consistently been low and stable from 0.14 to 0.15 deaths per 100,000 working-age population. Geographic differences between the provinces were evident. The risk of hospitalization and death due to asthma was higher in the Pacific coast (five provinces) and the Andean region (two provinces). The high rates observed in provinces with greater agricultural and industrial development could be the main determinants of national heterogeneity and could act as occupational risk factors. The contribution of occupational hazards in each province should be examined in depth through ad hoc studies. These findings provide valuable information for creating public policies aimed at promoting and safeguarding the respiratory health of the popu-lation, particularly that of workers.
... Scientists have determined that various types of occupational hazards (dust, gases, smoke, vapors, and others) that can act in the workplace can cause the development of AR through immunological or irritating non-immunological mechanisms [2][3][4]. This position is supported by the working group of the European Academy of Allergy and Clinical Immunology, which pointed out the close interaction between the upper and lower respiratory tracts and proposed the appropriate classification of AR subphenotypes, which is similar to occupational asthma [5][6][7]. ...
Introduction. Various types of occupational hazards can cause the development of occupational atrophic rhinitis (AR). Researches determine the high prevalence of professional AR among workers in various fields of production. Drug treatment of RA is an important issue. The effectiveness of the use of autologous platelet-enriched plasma is determined. Determining the possibilities of increasing the effectiveness of treatment of professional AR with platelet-enriched plasma is a very relevant issue of modern medicine. The aim. To evaluate the use of autologous platelet-rich plasma in occupational chronic AR compared to standard treatment (irrigation with oil solutions). Materials and methods. 141 patients were examined: I group (32.6%) received irrigation with oil solutions, II (39.7%) – injections of platelet-rich plasma, and III (27.7%) – injections of platelet-rich plasma and irrigation with oil solutions. Results. Significant (p < 0.001) chances of improvement in quality of life levels were found in groups I and II compared to III one month after treatment, based on decreases in the values of the NOSE scale (respectively by 0.946 points and by 5.285 points) and increases values in the SF-36 questionnaire (RE scale and RR by 13.899 points; p = 0.004 and by 15.914 points only with combined treatment; MH scale – by 4.028 points and by 17.880 points; VT scale – by 5.136 points; p = 0.005 and by 24.158 points). Significant (p < 0.001) chances of an increase in nasocytogram indicators were determined in groups I and II compared to III: respectively, the pH of mucus (by 1.029 and by 1.333), the quantitative composition of neutrophils (by 18.958% and by 21.078%) and eosinophils (by 3.540%) combined treatment only) and saccharin test indicators (at 0.3 min; p = 0.005 and at 1.696 min). Conclusions. An improvement in the quality of life and parameters of the nasocytogram and saccharin test was determined when injections of platelet-rich plasma were used (both separately and in combination with irrigation with oil solutions) in patients with occupational chronic AR. Reliable chances of a decrease in NOSE scale values and an increase in SF-36 questionnaire indicators and chances of an increase in nasocytogram and saccharin test indicators were established.
... This disparity supports our hypothesis that occupational asthma is under-recognised. 33 Occupational exposures to irritants may also be associated with a specific asthma phenotype, which is less documented and may not commonly be recognised as asthma. This was previously suggested in a study of healthcare workers, in which exposure to disinfection products was associated with a profile 'undiagnosed/untreated asthma' (identified by hierarchical clustering), characterised by numerous asthma symptoms, but low proportion of physician-diagnosed asthma and moderate use of asthma medications. ...
Objectives
The impact of chronic occupational exposures to irritants on asthma remains discussed. We studied the associations between occupational exposures and asthma, with specific interest for chronic exposure to irritants, including disinfectants and cleaning products (DCPs) and solvents.
Methods
Cross-sectional analyses included 115 540 adults (55% women, mean age 43 years, 10% current asthma) working at inclusion in the French population-based CONSTANCES cohort (2012–2020). Current asthma was defined by ever asthma with symptoms, medication or asthma attacks (past 12 months), and the asthma symptom score by the sum of 5 respiratory symptoms (past 12 months). Both lifetime and current occupational exposures were assessed by the Occupational Asthma-specific Job-Exposure Matrix. Associations were evaluated by gender using logistic and binomial negative regressions adjusted for age, smoking status and body mass index.
Results
In women, associations were observed between current asthma and lifetime exposure to irritants (OR 1.05, 95% CI 1.00 to 1.11), DCPs (1.06, 95% CI 1.00 to 1.12) and solvents (1.06, 95% CI 0.98 to 1.14). In men, only lifetime exposure to DCPs (1.10, 95% CI 1.01 to 1.20) was associated with current asthma. Lifetime exposure to irritants was associated with higher asthma symptom score both in women (mean score ratio: 1.08, 95% CI 1.05 to 1.11) and men (1.11, 95% CI 1.07 to 1.15), especially for DCPs (women: 1.09, 95% CI 1.06 to 1.13, men: 1.21, 95% CI 1.15 to 1.27) and solvents (women 1.14, 95% CI 1.10 to 1.19, men: 1.10, 95% CI 1.05 to 1.15). For current exposures, no consistent associations were observed with current asthma and asthma symptom score.
Conclusions
Lifetime occupational exposures to irritants were associated with current asthma and higher asthma symptom score. These exposures should be carefully considered in asthma management.
... Asthma burden remained high after retirement, suggesting cumulative and lagged effects. After repeating exposure to low levels of asthmagens (occupations like professional cleaners, pastry chefs, and oil sprayers), asthma developed insidiously over time [40]. Worse still was even if occupational asthma patients were removed from exposure, respiratory symptoms persisted and aggravated [41]. ...
Background
Change in asthma burden attributed to specific environmental risk factor has not been evaluated.
Objective
We aimed to explore the age, period, and cohort effects on asthma burden attributable to smoking and occupational asthmagens in different socio-demographic index (SDI) regions and the region and sex disparities.
Methods
Risk factor-specific asthma deaths and disability-adjusted life years (DALYs) rates were extracted from Global Burden of Disease study 2019, estimated by standard Combined Cause of Death Model and DisMod-MR 2.1 modeling tool. Age-period-cohort analysis was conducted to decompose age, period, and cohort effects on asthma burden.
Results
Smoking- and occupational asthmagens-related asthma deaths and DALYs rates dropped by > 45% during 1990–2019. In 2019, Africa, South and Southeast Asia had higher asthma burden than other regions. Male had higher asthma burden than female. Among nearly all age groups, low-middle SDI region had the highest smoking-related asthma burden, and low SDI region had the highest occupational asthmagens-related asthma burden. Inverse “V” shaped trend was observed in the above regions with increasing age. For smoking-related asthma deaths and DALYs rates, the most significant improvement of period rate ratio (RR) occurred in high SDI region, decreased from 1.67 (1.61, 1.74) to 0.34 (0.33, 0.36) and 1.61 (1.57, 1.66) to 0.59 (0.57, 0.61), respectively, as well as the cohort effect on smoking-related asthma burden. For occupational asthmagens-related asthma deaths and DALYs rates, the most sharply decrease of period and cohort RR appeared in the high and high-middle SDI regions. Low SDI region showed least progress in period and cohort RR of smoking- and occupational asthmagens-linked asthma burden.
Conclusion
Smoking- and occupational asthmagens-related asthma burden sharply decreases, but region and sex disparities exist. Policy makers from low SDI region should reinforce tobacco control and prioritize workplace protection.
... Based on the underlying mechanisms that trigger asthma symptoms, work-related asthma can be categorized into two main types: occupational asthma, primarily caused by exposure in the workplace, and work-exacerbated asthma, which denotes the onset or exacerbation of asthma symptoms due to occupational exposure in individuals with pre-existing asthma conditions. Occupational asthma can further be classified into sensitizer-induced and irritant-induced occupational asthma (291,292). ...
Asthma remains a significant global health challenge. While both the incidence and mortality rates have shown a decline, older individuals with asthma exhibit not just more severe symptoms but also demonstrate an elevated mortality rate. This phenomenon could be attributed to the presence of chronic comorbidities that exert an influence on clinical outcomes among adult patients with asthma. This review aims to present various aspects of asthma comprehensively, including the prevalence, incidence, mortality rates, and causes of death in adult patients with asthma. Additionally, this review delves into the impact of chronic comorbidities that contribute to the morbidity and mortality of patients with asthma on a global scale, encompassing conditions such as chronic kidney disease, diabetes mellitus, lung cancer, obesity, and cardiovascular disease, concerning asthma. Furthermore, the manuscript reviews the distinctions between asthma and asthma chronic obstructive pulmonary disease overlap and adds perspective on asthma as an occupational lung disease. Thus, this review aims to enhance clinicians’ awareness of the significance of chronic comorbidities in the management of patients with asthma. It seeks to provide insights that contribute to a more comprehensive approach to managing patients with asthma who also have comorbid conditions.
... Occupational asthma represents a significant public health concern due to its increased prevalence and critical social and economic burden (29). This observational study on a representative population from Western Romania shows that uncontrolled asthma, occupational exposure to various noxious substances, and impaired lung function are solid predictors for exacerbation. ...
Background:
Work-related asthma has become a highly prevalent occupational lung disorder.
Objective:
Our study aims to evaluate occupational exposure as a predictor for asthma exacerbation.
Method:
We performed a retrospective evaluation of 584 consecutive patients diagnosed and treated for asthma between October 2017 and December 2019 in four clinics from Western Romania. We evaluated the enrolled patients for their asthma control level by employing the Asthma Control Test (ACT < 20 represents uncontrolled asthma), the medical record of asthma exacerbations, occupational exposure, and lung function (i.e. spirometry). Then, we used statistical and data mining methods to explore the most important predictors for asthma exacerbations.
Results:
We identified essential predictors by calculating the odds ratios (OR) for the exacerbation in a logistic regression model. The average age was 45.42 ± 11.74 years (19-85 years), and 422 (72.26%) participants were females. 42.97% of participants had exacerbations in the past year, and 31.16% had a history of occupational exposure. In a multivariate model analysis adjusted for age and gender, the most important predictors for exacerbation were uncontrolled asthma (OR 4.79, p < .001), occupational exposure (OR 4.65, p < .001), and lung function impairment (FEV1 < 80%) (OR 1.15, p = .011). The ensemble machine learning experiments on combined patient features harnessed by our data mining approach reveal that the best predictor is professional exposure, followed by ACT.
Conclusions:
Machine learning ensemble methods and statistical analysis concordantly indicate that occupational exposure and ACT < 20 are strong predictors for asthma exacerbation.
... 16 Housewives face significant exposures that trigger allergy and asthma symptoms. Meanwhile, Tiotiu, et al. (2020) found that adults with asthma with full-time occupations who were younger and more often had non-manual occupations, experienced fewer asthma symptoms, used fewer asthma medications, and smoked less than subjects with occupation disabilities. 17 Moreover, Mungan, et al. (2019) showed that asthma patients had significant exposures to occupations that worsened their symptoms. ...
... Meanwhile, Tiotiu, et al. (2020) found that adults with asthma with full-time occupations who were younger and more often had non-manual occupations, experienced fewer asthma symptoms, used fewer asthma medications, and smoked less than subjects with occupation disabilities. 17 Moreover, Mungan, et al. (2019) showed that asthma patients had significant exposures to occupations that worsened their symptoms. 18 Hence, asthmatics and clinicians need to be educated about the prevalence and risks of exposure in the workplace (as well as at home) to minimize asthma triggers and exacerbations. ...
Introduction: Asthmatics, especially uncontrolled asthmatics, must be vigilant during the COVID-19 pandemic to avoid major respiratory complications. This study aimed to describe these characteristics in emergency unit patients with asthma and COVID-19 at Haji General Hospital, Surabaya, an East Java referral hospital.Methods:The study gathered medical information on 160 asthma patients from March to December 2021. The collected data were related to socioeconomics, allergy history, family allergy history, and medications.Results: 160 confirmed cases of asthma occurred during COVID-19 at Haji General Hospital, Surabaya. Most adult asthma sufferers were women (59.2%), high school graduates (31.25%), housewives (21.2%), had payment method with Social Health Insurance Administration Body (BPJS) insurance (73.8 %), had a history of drug allergies (11.5%), had no family history of allergies (50.8%), and used albuterol control drugs (10.7%). Meanwhile, the majority of children with asthma were boys (53.3%), did not attend school or did not finish elementary school (33.3%), didnot work (33.3%), had payment method with BPJS (73.3%), had a history of allergies to seafood and cow's milk respectively (10%), had no family history of allergies (40%), and used albuterol control drugs (16.7%).Conclusion:The proportion of asthma in the emergency unit was dominated by women over 18 years old with a high school education. Most patients were housewives and used BPJS. Many of them had a history of allergies to medications (not asthma medication), and there was no family history of allergies. Commonly used medications were albuterol to control asthma
... Asthma is common, and about 300 million people worldwide now have asthma. There are reports indicating that the incidence of asthma worldwide increases by 50% every decade (18). Patients with asthma show clinical signs such as wheezing, night cough, breath shortness, tightness of the chest, and variable limitations of expiratory airflow. ...
Lifestyle has historically been linked to the progression of different chronic diseases. The amount of convenience accessible for our use has expanded in the current period of modern technology, communication, and technological devices. Nevertheless, it has also resulted in an upsurge in issues related to emotional and mental wellness. Asthma, coronary heart disease (CHD), diabetes, lung cancer, and other disorders are all classified as lifestyle diseases. This theory contends that illnesses are brought on by an individual’s actions. The transition from an indigenous to a contemporary way of life, with high-fat and high-calorie meals paired with increasing emotional strain, has exacerbated the issue at hand. Obesity, asthma, diabetes, arthritis, hypertension, chronic liver disorders, CHD, metabolic syndrome, depression, and cancer are all on the rise due to alterations to dietary habits and an increasingly unhealthy way of life. According to joint research by the World Health Organization (WHO) and the World Economic Forum (WEF), India lost around $236.6 billion in 2015 as a result of a sedentary way of life and consumption of unhealthy foods. Unhealthy eating, decreased physical activity, increased cigarette smoking, excessive alcohol consumption, insufficient sleep, and anxiety due to increasing job pressure are all examples of poor lifestyle choices.
... Currently, knowledge of OA is growing, especially in clinical phenotypes, biomarkers, diagnosis, and management strategies [8]. However, the number of irritants in food industries is also growing, alongside technology and development progress [9]. ...
... Employers must provide a safe and conducive working environment, such as proper ventilation and PPE, as poor ventilation can affect the health of food industrial workers [19]. Additionally, particulate or bioaerosol detection device can be implemented by the employers to continuously assess their working condition [8]. Periodic medical surveillance should also be conducted to assess and detect any possible risk in developing OA [21]. ...
Introduction:
Occupational asthma (OA) is a type of Work-Related Asthma characterised by variable airflow limitation and/or inflammation due to causes and conditions attributable to a particular occupational environment, and not to stimuli encountered outside the workplace. There is an increasing need to extend the depth of knowledge of OA to better manage this condition, especially among food industry workers who are affected by it.
Objective:
This systematic review aimed to determine the factors associated with occupational asthma among food industry workers by electronically collecting articles from two databases (Medline and Scopus).
Methods:
This systematic review was prepared in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) updated guideline. Two independent reviewers screened the titles and abstracts of the collected data, which were then stored in Endnote20 based on the inclusion and exclusion criteria. The included articles have been critically appraised to assess the quality of the studies using the Mixed Methods Appraisal Tool (MMAT).
Result:
The search yielded 82 articles from Medline and 85 from SCOPUS, resulting in 167 unique hits. Only 22 articles have been included in the full-text assessment following a rigorous selection screening. Of the 22 articles identified, five were included in the final review. Several factors were found to have contributed to occupational asthma among food industry workers. They were classified into two categories: (1) work environment-related factors; and (2) individual factors.
Conclusion:
Several work environment and individual-related factors were found to be associated with OA among food industry workers. A better understanding of the development of the disease and its potential risk factors is needed because it can affect worker's quality of life. Pre-employment and periodic medical surveillance should be conducted to assess and detect any possible risk of developing occupational asthma among workers.
... We showed that people aged 60-64 years old had the highest asthma death and DALYs rate attributed to occupational asthmagens, which was similar with the previous studies [39], and asthma burden remained high after retirement, suggesting cumulative and lagged effect. After repeating exposure to lower levels of exposure (occupations like professional cleaners, pastry chefs, and oil sprayers), asthma developed insidiously over time [40]. Worse still was even if occupational asthma patients were removed from exposure, respiratory symptoms persisted and aggravated [41]. ...
Background: Change in asthma burden attributed to specific environmental risk factor has not been evaluated.
Objective: We aimed to explore the age, period, and cohort effects on asthma burden attributable to smoking and occupational asthmagens in different socio-demographic index (SDI) areas and the regional and gender differences.
Methods: Risk factor-specific asthma death and disability-adjusted life years (DALYs) rates were extracted from Global Burden of Disease study 2019, estimated by standard Combined Cause of Death Model and DisMod-MR 2.1 modeling tool. Age-period-cohort analysis was conducted to decompose age, period, and cohort effects on asthma burden.
Results: Smoking- and occupational asthmagens-related asthma death and DALYs rates dropped by >45% during 1990-2019. In 2019, Africa, South and Southeast Asia had higher asthma burden than other regions, and male had higher asthma burden than female. Among nearly all age groups, low-middle SDI region had the highest smoking-related asthma burden, and low SDI region had the highest occupational asthmagens-related asthma burden. Inverse “V” shaped trend was observed in the above regions with increasing age. For smoking-related asthma death and DALYs rates, the most significant improvement of period rate ratios (RRs) occurred in high SDI area, decreased from 1.67 (1.61, 1.74) to 0.34 (0.33, 0.36) and 1.61 (1.57, 1.66) to 0.59 (0.57, 0.61), respectively, as well as the cohort effect on smoking-related asthma burden. For occupational asthmagens-related asthma death and DALYs rates, the most sharply decrease of period and cohort RRs appeared in the high and high-middle SDI region, respectively. Low SDI area showed least progress in period and cohort RRs of smoking- and occupational asthmagens-linked asthma burden.
Conclusion: Smoking and occupational asthmagens-related asthma burden sharply decreases, but region and sex disparities exist. Policy makers from low SDI region should reinforce tobacco control and make more effort in occupational protection.
