Riassunto

• Should be suspected in all adult patients with asthma.
• An occupational history should be taken to identify work-related causes. Details of work exposures should be obtained from material safety data sheets and other material available to the patient from their workplace.
• Objective evidence of asthma should be obtained from spirometry, a bronchodilator response, and/or a methacholine challenge. Tests should be performed when the patient is symptomatic and/or within days of having exposure to a suspected aetiological agent.
• If sensitiser-induced occupational asthma is suspected, additional testing of asthma should be done, preferably while the patient is still working. Whenever possible an immunological response to a suspected work sensitiser should be demonstrated by skin or in vitro tests.
• Where possible, an early diagnosis based on as much objective data as is available should be made.
• In sensitiser-induced occupational asthma, removal from any further exposure to that agent should be recommended.
• In irritant-induced occupational asthma, preventive measures should be implemented in the workplace to reduce future exposures and episodes.
• For all causes of occupational asthma, the clinician should continue treating the asthma as appropriate, assist in the initiation of any appropriate compensation claim, and consider other workers at risk.