title: An official american thoracic society statement: work-exacerbated asthma.
abstract: BACKGROUND
  Occupational exposures can contribute to the exacerbation as well as the onset of asthma. However, work-exacerbated asthma (WEA) has received less attention than occupational asthma (OA) that is caused by work.
  
  
  OBJECTIVE
  The purpose of this Statement is to summarize current knowledge about the descriptive epidemiology, clinical characteristics, and management and treatment of WEA; propose a case definition for WEA; and discuss needs for prevention and research.
  
  
  METHODS
  Information about WEA was identified primarily by systematic searches of the medical literature. Statements about prevention and research needs were reached by consensus.
  
  
  RESULTS
  WEA is defined as the worsening of asthma due to conditions at work. WEA is common, with a median prevalence of 21.5% among adults with asthma. Different types of agents or conditions at work may exacerbate asthma. WEA cases with persistent work-related symptoms can have clinical characteristics (level of severity, medication needs) and adverse socioeconomic outcomes (unemployment, reduction in income) similar to those of OA cases. Compared with adults with asthma unrelated to work, WEA cases report more days with symptoms, seek more medical care, and have a lower quality of life. WEA should be considered in any patient with asthma that is getting worse or who has work-related symptoms. Management of WEA should focus on reducing work exposures and optimizing standard medical management, with a change in jobs only if these measures are not successful.
  
  
  CONCLUSIONS
  WEA is a common and underrecognized adverse outcome resulting from conditions at work. Additional research is needed to improve the understanding of the risk factors for, and mechanisms and outcomes of, WEA, and to inform and evaluate preventive interventions.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Henneberger
authors.forename: Carrie A
authors.initials: CA
authors.lastname: Redlich
authors.forename: David B
authors.initials: DB
authors.lastname: Callahan
authors.forename: Philip
authors.initials: P
authors.lastname: Harber
authors.forename: Catherine
authors.initials: C
authors.lastname: Lemière
authors.forename: James
authors.initials: J
authors.lastname: Martin
authors.forename: Susan M
authors.initials: SM
authors.lastname: Tarlo
authors.forename: Olivier
authors.initials: O
authors.lastname: Vandenplas
authors.forename: Kjell
authors.initials: K
authors.lastname: Torén
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D018450:Disease Progression; D006801:Humans; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects* / Q000517:prevention & control; D012955:Societies, Medical; D014481:United States / Q000453:epidemiology