Occupational Asthma Reference

Baur X, Sigsgaard T, Aasen TB, Burge PS, Heederik D, Henneberger P, Maestrelli P, Rooyackers J, Schlunssen V, Vandenplas O, Wilken D on behalf of the ERS Task Force on the Management of Work-related Asthma, Guidelines for the management of work-related asthma, Eur Respir J, 2012;39:529-545,

Keywords: Guidelines, ERS, occupational asthma, key

Known Authors

Paul Henneberger, NIOSH, Morgantown, USA Paul Henneberger

Olivier Vandenplas, Universite Mont-Goginne, Yvoir Olivier Vandenplas

Sherwood Burge, Oasys Sherwood Burge

Dick Heederik, Institute of Risk Assessment Sciences, Utrecht Dick Heederik

Torben Sigsgaard, University of Aarhus Torben Sigsgaard

Tor Aasen, Haukeland University Hospital, Bergen Tor Aasen

Xaver Baur, Institute of occupational medicine, Hamburg Xaver Baur

Piero Maestrelli, Padova University, Italy Piero Maestrelli

Vivi Schlunssen, Aarhus Vivi Schlunssen

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Abstract

Work-related asthma, which includes occupational asthma and work-aggravated
asthma, has become one of the most prevalent occupational lung diseases. These guidelines aim to upgrade occupational health standards, contribute importantly to transnational legal harmonisation and reduce the high socio-economic burden caused by this disorder. A systematic literature search related to five key questions was performed: diagnostics; risk factors; outcome of management options; medical screening and surveillance; controlling exposure for primary prevention. Each of the 1,329 retrieved papers was reviewed by two experts,followed by Scottish Intercollegiate Guidelines Network grading, and formulation of statements graded according to the Royal College of General Practitioners’ three-star system.
Recommendations were made on the basis of the evidence-based statements, which comprise the following major evidence-based strategic points.
1) A comprehensive diagnostic approach considering the individual specific aspects is recommended.
2) Early recognition and diagnosis is necessary for timely and appropriate preventative measures.
3) A stratified medical screening strategy and surveillance programme should be applied to at-risk workers. 4) Whenever possible,removing exposure to the causative agent should be achieved, as it leads to the best health outcome. If this is not possible, reduction is the second best option, whereas respirators are of limited value.
5) Exposure elimination should be the preferred primary prevention approach.

Plain text: Work-related asthma, which includes occupational asthma and work-aggravated asthma, has become one of the most prevalent occupational lung diseases. These guidelines aim to upgrade occupational health standards, contribute importantly to transnational legal harmonisation and reduce the high socio-economic burden caused by this disorder. A systematic literature search related to five key questions was performed: diagnostics; risk factors; outcome of management options; medical screening and surveillance; controlling exposure for primary prevention. Each of the 1,329 retrieved papers was reviewed by two experts,followed by Scottish Intercollegiate Guidelines Network grading, and formulation of statements graded according to the Royal College of General Practitioners' three-star system. Recommendations were made on the basis of the evidence-based statements, which comprise the following major evidence-based strategic points. 1) A comprehensive diagnostic approach considering the individual specific aspects is recommended. 2) Early recognition and diagnosis is necessary for timely and appropriate preventative measures. 3) A stratified medical screening strategy and surveillance programme should be applied to at-risk workers. 4) Whenever possible,removing exposure to the causative agent should be achieved, as it leads to the best health outcome. If this is not possible, reduction is the second best option, whereas respirators are of limited value. 5) Exposure elimination should be the preferred primary prevention approach.

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