What is the prognosis of occupational asthma?

The following references have been associated with this question by users of this website. They do not form part of the BOHRF occupational asthma guidelines.

Cedd Burge Anees 2006 Partial relocation not effective in reducing FEV1 decline
burgeps Maghni 2004
burgeps Brant 2006 Symptomatic improvement not related to the level of specific IgE while exposed (this is not surprising as exposure to detergent enzymes is unlikely outside the workplace). The situation may be different if low level exposure was possible in the normal environment.
burgeps Park 2007 11 workers with positive specific challenges to reactive dyes were followed up for a mean of 13 years. Symptomatic continued exposure mean 2.4 (SD 1.8) years, follup up at 4 and 13 years post presentation. There was no significant improvement in symptoms, methacholine reactivity or FEV1 at 13 years, although specific IgE usual became negative at 13 years
burgeps Rachiotis 2007 You can find an individual paper that supportsrecovery in anything from 0-100%, however there are a large number of workers who do not make a complete recovery (an estimate of 70% with great inhomogeneity)
burgeps Yacoub 2007 5/40 (12.5%) were considered cured 2 years after a diagnosis of occupational asthma in Montreal. 8 (20%) had been successfully relocated away from exposure by their original employer and 13 (32.5%) were working for a different employer. 7 (17.5%) were retired prematurely, 7 were unemployed or doing part-time work and 5 (12.5%) were being retrained. FEV1 had not improved at follow-up, but non-specific reactivity and sputum eosinophilia had improved. 52.5% were abnormally anxious and 47.5% depressed using the PSI questionnaire at follow-up.
burgeps Labrecque 2006 A follow-up of compensated cases in Quebec showed no overall improvement in FEV1 after removal from exposure, and normalisation of NSBR in 11% with significant inprovement in 24%. Clinical remission occured in 5%.
Cedd Burge Piirilä 2008 This confirms the relatively poor prognosis with continuing inflammation after removal from exposure.
burgeps Munoz 2008
burgeps Malo 2004
burgeps Pisati 2007
burgeps Bernstein 2003
burgeps Rüegger 2014
burgeps Patel 2018 Asthma mortality is fortunately declining, and reported cases due to occupational asthma rare. This study from the USA reports proportional mortality from asthma related to broad occupational groups. The highest proportional mortality in men (1.82) is in the food, beverage, and tobacco product manufacturing industry, which included bakers and others making pre-prepared food and drinks, many of which contain genetically modified enzymes that are potential sensitisers and can lead to very acute reactions. This study should alert those responsible for occupational health in these industries to revise their risk assessments.
burgeps Lantto 2022

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