REVIEW PAPER
Update on work-exacerbated asthma
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University of Toronto, Toronto, Ontario, Canada
(Toronto Western Hospital)
Corresponding author
Susan M. Tarlo
Toronto Western Hospital, EW7-449, 399 Bathurst St, Toronto, Ontario, M5T 2S8 Canada
Int J Occup Med Environ Health. 2016;29(3):369-74
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ABSTRACT
Work-exacerbated asthma (WEA) is the term used to describe the worsening of asthma related to work but not the causation
of asthma by work. It is common and has been reported to occur for 21.5% of working asthmatics on average. The frequency
and severity may range from a single mild exacerbation that may lead to no time lost at work up to daily or severe
exacerbations that may require a permanent change in work. Reports from general population surveys and primary care
settings include more patients with short-term or mild exacerbations while those from tertiary care settings reflect the more
severe end of the spectrum of severity or frequency, with socioeconomic outcomes that are similar to those of occupational
asthma. In the minority of patients with the WEA, whose asthma starts while working, the differential diagnosis includes
sensitizer-induced or possible irritant-induced occupational asthma. Optimizing work exposures and asthma management
may improve outcome and prevent exacerbations. Worker education and screening of working asthmatics by primary health
care workers may also prevent morbidity.