title: Diagnosis and management of work-related asthma: American College Of Chest Physicians Consensus Statement.
abstract: BACKGROUND
  A previous American College of Chest Physicians Consensus Statement on asthma in the workplace was published in 1995. The current Consensus Statement updates the previous one based on additional research that has been published since then, including findings relevant to preventive measures and work-exacerbated asthma (WEA).
  
  
  METHODS
  A panel of experts, including allergists, pulmonologists, and occupational medicine physicians, was convened to develop this Consensus Document on the diagnosis and management of work-related asthma (WRA), based in part on a systematic review, that was performed by the University of Alberta/Capital Health Evidence-Based Practice and was supplemented by additional published studies to 2007.
  
  
  RESULTS
  The Consensus Document defined WRA to include occupational asthma (ie, asthma induced by sensitizer or irritant work exposures) and WEA (ie, preexisting or concurrent asthma worsened by work factors). The Consensus Document focuses on the diagnosis and management of WRA (including diagnostic tests, and work and compensation issues), as well as preventive measures. WRA should be considered in all individuals with new-onset or worsening asthma, and a careful occupational history should be obtained. Diagnostic tests such as serial peak flow recordings, methacholine challenge tests, immunologic tests, and specific inhalation challenge tests (if available), can increase diagnostic certainty. Since the prognosis is better with early diagnosis and appropriate intervention, effective preventive measures for other workers with exposure should be addressed.
  
  
  CONCLUSIONS
  The substantial prevalence of WRA supports consideration of the diagnosis in all who present with new-onset or worsening asthma, followed by appropriate investigations and intervention including consideration of other exposed workers.
authors.affiliation: University of Toronto, Toronto, ON, Canada. Electronic address: susan.tarlo@utoronto.ca.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Tarlo
authors.affiliation: University of California San Francisco, San Francisco, CA.
authors.forename: John
authors.initials: J
authors.lastname: Balmes
authors.affiliation: National Jewish Medical and Research Center, Denver, CO.
authors.forename: Ronald
authors.initials: R
authors.lastname: Balkissoon
authors.affiliation: University of Alberta, Calgary, AB, Canada.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Beach
authors.affiliation: University of Rochester School of Medicine and Dentistry, Rochester, NY.
authors.forename: William
authors.initials: W
authors.lastname: Beckett
authors.affiliation: University of Cincinnati, Cincinnati, OH.
authors.forename: David
authors.initials: D
authors.lastname: Bernstein
authors.affiliation: University of California San Francisco, San Francisco, CA.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Blanc
authors.affiliation: University of South Florida, Tampa, FL.
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Brooks
authors.affiliation: Mayo Clinic, Rochester, MN.
authors.forename: Clayton T
authors.initials: CT
authors.lastname: Cowl
authors.affiliation: State University of New York, Stony Brook, NY.
authors.forename: Feroza
authors.initials: F
authors.lastname: Daroowalla
authors.affiliation: University of California, Los Angeles, Los Angeles, CA.
authors.forename: Philip
authors.initials: P
authors.lastname: Harber
authors.affiliation: Université de Montréal, Montréal, QC, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Lemiere
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Liss
authors.affiliation: National Jewish Medical and Research Center, Denver, CO.
authors.forename: Karin A
authors.initials: KA
authors.lastname: Pacheco
authors.affiliation: Yale University School of Medicine, New Haven, CT.
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Redlich
authors.affiliation: University of Alberta, Calgary, AB, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Rowe
authors.affiliation: American College of Chest Physicians, Northbrook, IL.
authors.forename: Julia
authors.initials: J
authors.lastname: Heitzer
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003245:Consensus Statements as Topic; D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D017063:Outcome Assessment, Health Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D014481:United States