title: New developments in work-related asthma.
abstract: Work-related asthma includes two subtypes: occupational asthma or asthma caused by specific agents (sensitizers or irritants) in the workplace, and work-exacerbated asthma or pre-existing asthma worsened by workplace exposures. Areas covered: This review provides an update on the definitions and the clinical features of the different work-related asthma subtypes as well as new insights into their etiology and the pathophysiological mechanisms involved. The diagnosis of work-related asthma should be made on objective basis using a constellation of clinical, physiologic and allergologic tests. Specific inhalation challenge with the suspected occupational agent(s) remains as the reference standard for diagnosis. A literature search was performed using the following terms: work-related asthma, occupational asthma, work-exacerbated asthma, irritant-induced asthma and etiological agents. Expert commentary: Studies focusing on the biological effects and mechanisms of environmental exposures in the development of sensitizer-induced or irritant-induced asthma in various workplace settings are of greatest interest. An integrative approach that combines clinical parameters with component-resolved diagnosis as well as inflammatory biomarkers appears to be very promising. Occupational allergy provides a good opportunity to understand the complex relationships between exposure to allergens in the workplace, interaction with genes and the co-exposures to other factors in the working environment.
authors.affiliation: a Department of Allergy , Hospital La Paz Institute for Health Research and CIBER of Respiratory Diseases, CIBERES , Madrid , Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Quirce
authors.affiliation: b Unidad de Gestión Clínica Allergy-IBIMA , Hospital Regional Universitario , Malaga , Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Campo
authors.affiliation: a Department of Allergy , Hospital La Paz Institute for Health Research and CIBER of Respiratory Diseases, CIBERES , Madrid , Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Domínguez-Ortega
authors.affiliation: c Department of Allergy , Fundación Jiménez Díaz , Madrid , Spain.
authors.forename: Mar
authors.initials: M
authors.lastname: Fernández-Nieto
authors.affiliation: d Allergy Section , Hospital General Universitario , Ciudad Real , Spain.
authors.forename: Elisa
authors.initials: E
authors.lastname: Gómez-Torrijos
authors.affiliation: e Department of Allergy , Hospital Universitario Araba , Vitoria-Gasteiz , Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Martínez-Arcediano
authors.affiliation: f Allergy Unit , Hospital Santa Barbara , Puertollano , Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Mur
authors.affiliation: g Unidad de Gestión Clínica Alergología , Hospital Virgen Macarena , Sevilla , Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Delgado
mesh_terms: D000485:Allergens / Q000276:immunology; D000818:Animals; D059366:Asthma, Occupational / Q000175:diagnosis*; D015415:Biomarkers / Q000378:metabolism; D001985:Bronchial Provocation Tests; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis*; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D007509:Irritants / Q000276:immunology; D016273:Occupational Exposure / Q000009:adverse effects
chemical_list: D000485:Allergens; D015415:Biomarkers; D018836:Inflammation Mediators; D007509:Irritants
keywords: Work-related asthma; biomarkers; component-resolved diagnosis; irritant-induced asthma; occupational exposures; work-exacerbated asthma