Reference

Cortona G, Pisati G, Dellabianca A et al, Allergopatie professionali respiratorie: l'esperienza delle Unita Operative Ospedaliere di Medicina del Lavoro in Lombardia dal 1990 al 1998. [Respiratory occupational allergies: the experience of the Hospital Operative Unit of Occupational Medicine in Lombardy from 1990 to 1998], G Ital Med Lav Ergon, 2001;23:64-70,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

A study on occupational rhinitis and asthma diagnosed in 7 occupational health institutes was performed. 141 cases of rhinitis and 281 cases of asthma due to sensitisation to occupational agents were analyzed and their clinical characteristics, aetiology, diagnostic methods and associated allergic diseases were determined. In this population the most frequent agents of occupational rhinitis were wheat flour and latex, whereas those of occupational asthma were latex and isocyanate. More than half of the subjects had more than one clinical manifestation of allergy. In 92/281 asthmatic patients, rhinitis was the first clinical manifestation, particularly in subjects sensitized to high molecular weight substances, and preceded, asthma by 12 months as a mean. Specific bronchial provocation tests were useful for the diagnosis of asthma in 153 of asthmatic patients and 45 of them had an isolated late bronchial reaction following the specific stimulus. At diagnosis 61 subjects (21.7%) had FEV1 < 80% of predicted; factors associated to ventilatory impairment were sensitisation to high molecular weight substances, duration of exposure to the sensitizing agent, persistence of exposure after onset of symptoms.

BOHRF Associated Evidence Statements

The BOHRF occupational asthma guidelines state that this reference is associated with the following evidence statements

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The reported incidence of occupational asthma has not decreased in recent years.

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The most frequently reported agents include isocyanates, flour and grain dust, colophony and fluxes, latex, animals, aldehydes and wood dust.

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Occupational rhinitis and occupational asthma frequently occur as co-morbid conditions in IgE associated occupational asthma.

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Rhino-conjunctivitis is more likely to appear before the onset of IgE associated occupational asthma.

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The risk of developing occupational asthma is highest in the year after the onset of occupational rhinitis.