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Eosinophilic bronchitis in the workplace

Quirce, Santiago

Current Opinion in Allergy and Clinical Immunology: April 2004 - Volume 4 - Issue 2 - p 87-91
Occupational disease
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Purpose of review The purpose of this review is to report that eosinophilic bronchitis without asthma may occur as an occupational airway disease. This condition is characterized by cough that is responsive to corticosteroids and eosinophilia detectable in the sputum, without variable airflow obstruction or airway hyperresponsiveness.

Recent findings Eosinophilic bronchitis can be regarded as an occupational respiratory disorder when it develops as a consequence of work exposures. Recently, exposure to certain occupational allergens or sensitizers, such as natural rubber latex, mushroom spores, acrylates and an epoxy resin hardener, have been reported to cause eosinophilic bronchitis without asthma. Several hypotheses have been put forward trying to explain why patients with eosinophilic bronchitis do not have airway hyperresponsiveness. It is unknown whether eosinophilic bronchitis may progress to typical occupational asthma, or if eosinophilic airway inflammation may persist when asthma symptoms and airway hyperresponsiveness have waned after the cessation of exposure to the occupational agent.

Summary Eosinophilic bronchitis, like asthma, may arise from occupational exposures. The examination of induced sputum should be added to the objective monitoring of lung function during periods at work and away from work, as well as before and after specific inhalation challenges with occupational agents.

Fundación Jiménez Díaz, Allergy Department, Madrid, Spain

Correspondence to Santiago Quirce, MD, PhD, Fundación Jiménez Díaz, Servicio de Alergia, Avda. Reyes Católicos, 2, 28040 Madrid, Spain Tel: +34 91 550 49 05; fax: +34 91 549 94 98; e-mail: sequirce@fjd.es

© 2004 Lippincott Williams & Wilkins, Inc.