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Medical surveillance for prevention of occupational asthma

Szram, Joanna; Cullinan, Paul

Current Opinion in Allergy and Clinical Immunology: April 2013 - Volume 13 - Issue 2 - p 138–144
doi: 10.1097/ACI.0b013e32835e1212
OCCUPATIONAL DISEASE: Edited by Susan M. Tarlo and Piero Maestrelli

Purpose of review Because there is sufficient knowledge of its environmental determinants, occupational asthma is a disease that ought to be largely preventable; yet its incidence in many settings remains unacceptably high. Here we review one approach to prevention: the routine use of health surveillance in exposed workforces.

Recent findings Health surveillance is widely practised but there is little evidence that it is used strategically to reduce disease incidence. There are several barriers to the effective use of its various components, chiefly symptoms questionnaires and spirometry. Cost–benefit analyses may help to increase the uptake of industry-wide workplace interventions.

Summary The effective use of health surveillance for occupational asthma continues to be challenging and there remains relatively little published evidence that will encourage those involved to use it more efficiently. Useful advances could be made by greater collaboration between employers, employee organizations, legislators and researchers.

aDepartment of Occupational and Environmental Medicine, National Heart and Lung Institute, Imperial College London

bRoyal Brompton and Harefield NHS Foundation Trust, London, UK

Correspondence to Professor Paul Cullinan, Department of Occupational and Environmental Medicine, Emmanuel Kaye Building, 1b Manresa Road, London SW3 6LR, UK. Tel: +44 207 351 8934; e-mail:

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.