Occupational Asthma Reference

Quirce S, Vandenplas O, Campo P, Cruz MJ, de Blay F, Koschel D, Moscato G, Pala G, M R, Sastre J, Siracusa A, Tarlo SM, Walusiak-Skorupa J, Cormier Y, Occupational hypersensitivity pneumonitis: An EAACI Position paper, Allergy, 2016;:,10.1111/all.12866

Keywords: HP, EAA, review

Known Authors

Olivier Vandenplas, Universite Mont-Goginne, Yvoir Olivier Vandenplas

Joaquin Sastre, Fundacion Jimenez Diaz, Madrid Joaquin Sastre

Maria Jesus Cruz, Barcelona Maria Jesus Cruz

Giana Moscato, Fondazione Salvatore Maugeri, Pavia Giana Moscato

Santiago Quirce, Madrid Santiago Quirce

Andrea Siracusa, Perugia Andrea Siracusa

Susan Tarlo, Toronto Susan Tarlo

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Abstract

The aim of this document is to provide a critical review of the current knowledge on hypersensitivity pneumonitis caused by the occupational environment and to propose practical guidance for the diagnosis and management of this condition. Occupational hypersensitivity pneumonitis (OHP) is an immunologic lung disease resulting from lymphocytic and frequently granulomatous inflammation of the peripheral airways, alveoli and surrounding interstitial tissue which develops as the result of a non-IgE mediated allergic reaction to a variety of organic materials or low-molecular-weight agents that are present in the workplace. The offending agents can be classified into six broad categories that include bacteria, fungi, animal proteins, plant proteins, low-molecular-weight chemicals, and metals. The diagnosis of OHP requires a multidisciplinary approach and relies on a combination of diagnostic tests in order to ascertain the work-relatedness of the disease. Both the clinical and the occupational history are keys to the diagnosis and often will lead to the initial suspicion. Diagnostic criteria adapted to OHP are proposed. The cornerstone of treatment is early removal from exposure to the eliciting antigen, although the disease may show an adverse outcome even after avoidance of exposure to the causal agent.

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