Clinical Evaluation of Work-Related Asthma

Evaluation of patients who experience asthma symptoms at work requires careful assessment and identification of the illness.

When a patient presents with symptoms which resemble airway hyperreactivity that occurs on the job, the physician must employ the usual tools for evaluation of any patient. Specifically, he or she has to take a thorough history to determine if the workplace has any clear connection with the medical condition [1, 3].

The history in these cases will include assessment of the workplace, work process, and review of material safety data sheets. Of great importance is the occurrence of symptoms and whether they take place at or away from the place of employment. In other words, the occurrence of symptoms at work and their resolution on weekends, vacations, and holidays will suggest that work-related asthma is the reason for the illness [1, 2, 3].

Tests of Lung Function

Naturally, there must be a physical examination and laboratory tests. Pulmonary function tests may yield useful data to confirm or exclude the diagnosis of work-related asthma. Moreover, the methacholine challenge test will assess airway hyperresponsiveness through provocation. This entails injection of a substance which induces airway hyperreactivity, and the physician observes how long it takes before the patient has that reaction [1, 3].

Though non-specific airway hyperresponsiveness may occur from provocation testing with methacholine, mannitol, adenosine, or histamine, this finding is not diagnostic of occupational asthma [1, 3].

Hence, there must be a test that produces a reaction from the agent which is responsible for the symptoms of work-related asthma. In essence, this confirms the diagnosis [1].

Early Detection of Disease

The conclusions from the diagnostic evaluation may determine whether the patient will be able to keep his or her employment. Accurate examination of these clients, therefore, is necessary. Moreover, early detection of the condition will enable the employee to have a better long-term prognosis than in cases where there is a delay in diagnosis [1, 2, 3].

Furthermore, correct diagnosis enables the physician to remove the irritant from the worker and facilitate a reasonably comfortable environment. In any event, the employer and the physician have to make recommendations about continuation of employment, new job assignment, vocational rehabilitation, disability claim, and job resignation [1, 2, 3].

Conclusion

Work-related asthma can place much stress and discomfort on workers and their families, and a competent medical team is essential to yield the best result.

References

1. Tan, J. and Bernstein, J. (2014). Occupational asthma: An overview. Current Allergy and Asthma Reports, 14, 431.

2. United States Department of Labor. (2014). Occupational asthma. Retrieved July 27, 2014.

3. University at Albany. School of Public Health. (2014). Work-related asthma: Recognition and diagnosis.

4. The photo is a 1939 image of workers in a ceramics factory where they may encounter exposure to airborne particulates. Reprinted with permission from Centers for Disease Control/Barbara Jenkins/National Institute for Occupational Safety and Health.

Disclaimer

The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 07/27/2014, Michael_Koger

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