Occupational asthma from chlorine-based cleaners?

Discussing Titan chlor plus with OH physician now convinced they are seeing “allergic” presentations rather than irritant. My bias remains irritant acting to aggravate underlying airways disease. Anyone seeing this in healthcare workers?
Anything to support allergic rather than irritant?
Occupational Asthma, Specialist, 6/12/2019, 6/12/2019,

We support allergic or at least hypersensitivity. We think that the problem with chlorine releasing agents is the production of chloramines with the addition of a protein source, similar to the problems in the air of indoor swimming pools. I think we have one positive SIC with a chlorine releasing agent without a protein source, but several when urea is added to the biocide during SIC.

Thickett KM, McCoach JS, Gerber JM, Sadra S, Burge PS, Occupational asthma caused by chloramines in swimming-pool air, Eur Respir J, 2002;19:827-832

Moore VC, Burge PS, Robertson AS, Walters GI, What causes occupational asthma in cleaners?, Thorax, 2017;72:581–583.,org/10.1136/ thoraxjnl-2016-208827

Walters GI, Burge PS, Moore VC, Robertson AS, Cleaning agent occupational asthma in the West Midlands, UK: 2000-16., Occup Med, 2018;68:530-536,10.1093/occmed/kqy113


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