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de la Hoz Rafael E. M.D. M.P.H.
Clinical Pulmonary Medicine: July 1998

Although occupational asthma (OA) probably accounts for 5% to 10% of the cases of asthma in adults, it is widely believed to be underreported. More than 200 agents are known or suspected to cause OA, and close to 8 million manufacturing and service sector workers are potentially exposed to one or more of those agents in the United States. In the investigation of a case of work-related asthma, aggravation of preexisting asthma needs to be distinguished from OA. Clinically, two main forms of OA are presently recognized: one is induced by respiratory irritants, and there is essentially no latency between exposure and development of symptoms. The other form is induced by a variety of agents, which cause the disease by a known (e.g., allergic, pharmacologic) or unknown mechanism, different from irritation, and a latency period can be recognized between exposure and symptoms. Although many cases of work-related asthma may require evaluation by experienced occupational specialists, early investigation of suspected cases by primary care practitioners and pulmonologists offers the best hope for increasing the detection of the condition and offering effective treatment. In this article, guidelines for initial evaluation and diagnosis are discussed.

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