Asthma, Occupational

Key Features

• Estimated 2–5% of all asthma cases are related to occupational factors

Clinical Findings

• Dyspnea, wheezing, and/or cough that correlate with the workplace

• Patients often report feeling better in the evenings or during weekends and vacations

• Symptoms may occur 4–8 hours after exposure to the offending antigen. This may occur after the patient has left work or even at night and thus may mimic paroxysmal nocturnal dyspnea

Diagnosis

• Requires a high index of suspicion and a careful history of workplace exposures

• Spirometry before and after exposure to the implicated substance

• Peak flow measurements at and outside of the workplace

• Bronchoprovocation testing is helpful in some cases

Treatment

• Bronchodilators

• Avoidance of further exposure to the offending agent