title: An official American Thoracic Society Workshop Report: presentations and discussion of the fifth Jack Pepys Workshop on Asthma in the Workplace. Comparisons between asthma in the workplace and non-work-related asthma.
abstract: The fifth Jack Pepys Workshop on Asthma in the Workplace focused on the similarities and differences of work-related asthma (WRA) and non-work-related asthma (non-WRA). WRA includes occupational asthma (OA) and work-exacerbated asthma (WEA). There are few biological differences in the mechanisms of sensitization to environmental and occupational allergens. Non-WRA and OA, when due to high-molecular-weight agents, are both IgE mediated; it is uncertain whether OA due to low-molecular-weight agents is also IgE mediated. Risk factors for OA include female sex, a history of upper airway symptoms, and a history of bronchial hyperresponsiveness. Atopy is a risk factor for OA due to high-molecular-weight agents, and exposure to cleaning agents is a risk factor for both OA and non-WRA. WEA is important among workers with preexisting asthma and may overlap with irritant-induced asthma, a type of OA. Induced sputum cytology can confirm airway inflammation, but specific inhalation challenge is the reference standard diagnostic test. Inhalation challenges are relatively safe, with the most severe reactions occurring with low-molecular-weight agents. Indirect health care costs account for about 50% of total asthma costs. Workers with poor asthma control (WRA or non-WRA) are less likely to be employed. Income loss is a major contributor to the indirect costs of WRA. Overall, asthma outcomes probably are worse for adult-onset than for childhood-onset asthma but better for OA than adult-onset non-WRA. Important aspects of management of OA are rapid and proper confirmation of the diagnosis and reduction of exposure to sensitizers or irritants at work and home.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Malo
authors.forename: Susan M
authors.initials: SM
authors.lastname: Tarlo
authors.forename: Joaquin
authors.initials: J
authors.lastname: Sastre
authors.forename: James
authors.initials: J
authors.lastname: Martin
authors.forename: Mohamed F
authors.initials: MF
authors.lastname: Jeebhay
authors.forename: Nicole
authors.initials: N
authors.lastname: Le Moual
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.forename: Thomas
authors.initials: T
authors.lastname: Platts-Mills
authors.forename: Paul D
authors.initials: PD
authors.lastname: Blanc
authors.forename: Olivier
authors.initials: O
authors.lastname: Vandenplas
authors.forename: Gianna
authors.initials: G
authors.lastname: Moscato
authors.forename: Frédéric
authors.initials: F
authors.lastname: de Blay
authors.forename: André
authors.initials: A
authors.lastname: Cartier
mesh_terms: D000485:Allergens / Q000276:immunology*; D059366:Asthma, Occupational / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D002170:Canada; D003226:Congresses as Topic; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D012955:Societies, Medical; D017132:Workplace
chemical_list: D000485:Allergens; D007073:Immunoglobulin E