Interstitial, Inflammatory, and Occupational Lung Disease/Obstructive Airways DiseaseOccupational Asthma. Current Practice When to Think of It, What to Do?Szram, Joanna PhD, MDAuthor Information Royal Brompton Hospital and National Heart and Lung Institute, Imperial College London, London, UK The author declares that she has nothing to disclose. Address correspondence to: Joanna Szram, PhD, MD, Department of Occupational and Environmental Medicine, Emmanuel Kaye Building, 1b Manresa Road, London SW3 6LR, UK. E-mail: [email protected]. Clinical Pulmonary Medicine: September 2012 - Volume 19 - Issue 5 - p 199-205 doi: 10.1097/CPM.0b013e3182670d09 Buy Metrics Abstract Exposures at work are an often overlooked but important cause of asthma and other airway diseases. Evidence from large population-based studies shows that 1 in 10 cases of asthma occurring, recurring, or worsening in adulthood can be related to occupational factors. The majority of cases are of pre-existing asthma made worse by employment [work-exacerbated asthma (WEA)]. Adults presenting with increased or new asthma symptoms should be carefully assessed so that WEA can be distinguished from true occupational asthma (OA), a disease that is directly caused by a workplace exposure. Airways disease may also arise from toxic exposures to respiratory irritants at work. In most cases, symptoms are self-limiting, but an asthma-like syndrome (irritant-induced asthma) occasionally results. OA and WEA require different diagnostic and management approaches. Key steps required to make a definitive diagnosis of either condition are an awareness of the disease with an associated low threshold of suspicion, time spent acquiring a full and detailed job history followed by carefully considered application of a few simple important diagnostic investigations. A satisfying part of managing OA is the opportunity for cure (provided that the necessary management advice can be implemented), although the socioeconomic consequences—mainly to the patient themselves—can be high. © 2012 Lippincott Williams & Wilkins, Inc.