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Work-Related Asthma: Diagnosis and Prognosis of Immunological Occupational Asthma and Work-Exacerbated Asthma


X Muñoz,1,2,3 MJ Cruz,1,2 V Bustamante,4 JL Lopez-Campos,2,5 E Barreiro2,6

1Pulmonology Service, Medicine Department, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
2Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
3Department of Cell Biology, Physiology and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain
4Pneumology Department, Hospital Universitario Basurto, Osakidetza/University of the Basque Country, Bilbao, Spain
5Unidad Médico-quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, Spain
6Pulmonology Department-Muscle Research and Respiratory System Unit (URMAR), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM)-Hospital del Mar, Department of Experimental and Health Sciences (CEXS), Universitat Pompeu Fabra, Parc de Recerca Biomèdica de Barcelona (PRBB), Barcelona, Spain

J Investig Allergol Clin Immunol 2014; Vol. 24(6): 396-405



The incidence and prevalence of asthma are increasing. One reason for this trend is the rise in adult-onset asthma, especially occupational asthma, which is 1 of the 2 forms of work-related asthma. Occupational asthma is defined as asthma caused by agents that are present exclusively in the workplace. The presence of pre-existing asthma does not rule out the possibility of developing occupational asthma. A distinction has traditionally been made between immunological occupational asthma (whether IgE-mediated or not) and nonimmunological occupational asthma caused by irritants, the most characteristic example of which is reactive airway dysfunction syndrome. The other form of work-related asthma is known as work-exacerbated asthma, which affects persons with pre-existing or concurrent asthma that is worsened by work-related factors. It is important to differentiate between the 2 entities because their treatment, prognosis, and medical
and social repercussions can differ widely. In this review, we discuss diagnostic methods, treatment, and avoidance/nonavoidance of the antigen in immunological occupational asthma and work-exacerbated asthma.

Key words: Specific inhalation challenge. Peak expiratory flow. Workplace. Irritants.