What is work-exacerbated asthma?

The article reviews the literature and adds a slant from Quebec. It starts with the ACCP definition of asthma present before first exposure to the provoking agent, followed by an increase in symptoms or treatment after entering the new occupational setting. Most agree that work-exacerbated asthma should not involve sensitisation, but should be by non-specific mechanisms. The problem is identifying the mechanism for asthma deterioration in an individual. Catherine Lemiere proposes the specific inhalation challenge as a method of differentiation. If positive the mechanism is by sensitisation, if negative it is work-exacerbated asthma; both are said to show similar deterioration in PEF at work. If the work exposure causes measurable drops in PEF and the specific challenge does not, surely the specific challenge has failed to reproduce the workplace exposure, unrelated to any mechanism?

References

	Lemiere C, Occupational and work-exacerbated asthma: similarities and differences, Expert Review of Respiratory Medicine, 2007;1:43-49,

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