ASTHMA: Edited by Zuzana Diamant and Nicola A. HananiaNovel approaches in occupational asthma diagnosis and managementQuirce, Santiagoa,b; Domínguez-Ortega, Javiera,b; Luna, Juan A.a,bAuthor Information aDepartment of Allergy, La Paz University Hospital, IdiPAZ bCIBER of Respiratory Diseases CIBERES, Madrid, Spain Correspondence to Santiago Quirce, Department of Allergy, La Paz University Hospital, IdiPAZ, P. La Castellana, 261, 28046 Madrid, Spain. E-mail: [email protected] Current Opinion in Pulmonary Medicine: January 2021 - Volume 27 - Issue 1 - p 9-14 doi: 10.1097/MCP.0000000000000737 Buy Metrics Abstract Purpose of review To describe the recent findings of the last 2 years on the epidemiology and phenotypes of occupational asthma, as well as new developments in its diagnosis and management. Recent findings Data from nine longitudinal studies showed a population attributable fraction for the occupational contribution to incident asthma of 16%. The main phenotypes of occupational asthma are: occupational asthma caused by high-molecular-weight (HMW) or low-molecular-weight (LMW) agents, irritant-induced asthma and occupational asthma-chronic obstructive pulmonary disease overlap. Among the variety of causative agents of occupational asthma, food-derived components are increasingly being reported, accounting for up to 25% cases of occupational asthma and/or occupational rhinitis. Recently, a specific inhalation challenge (SIC)-independent model has been developed to calculate the probability of occupational asthma diagnosis in workers exposed to HMW agents. In this model, work-specific sensitization, bronchial hyperresponsiveness, inhaled corticosteroid use, rhinoconjunctivitis and age 40 years or less were the most relevant predictive factors. Specific IgE measurements showed a pooled sensitivity of 0.74 and a specificity of 0.71 in the diagnosis of occupational asthma for HMW agents, while a lower sensitivity (0.28) and a higher specificity (0.89) was shown for LMW agents. Cessation of exposure to workplace sensitizers is the cornerstone of management of work-related conditions. Summary An early and precise diagnosis of occupational asthma is crucial, allowing appropriate management and implementation of preventive strategies. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.