Occupational asthma
小结
定义
病史和体格检查
关键诊断因素
- occupational exposure to sensitizing agents or irritants
- symptoms of asthma that improve during holidays
- initial onset of asthma symptoms during a work period
危险因素
- high-level exposure to sensitizer
- atopy
- genetic factors
- smoking
诊断性检查
首要检查
- spirometry
- chest x-ray
- skin prick testing (SPT)
- nonspecific bronchial hyper-responsiveness (NSBHR)
- serial peak expiratory flow (PEF)
需考虑的检查
- specific serum IgE assay
- specific inhalation challenge (SIC)
新兴检查
- induced sputum cytology
- fractional exhaled nitric oxide (FeNO)
治疗流程
sensitizer-induced
irritant-induced
symptomatic asthma
撰稿人
作者
Ryan Hoy, MB BS, MOEH, FRACP
Respiratory Physician
The Alfred Hospital
Melbourne
Victoria
Australia
利益声明
RH is an author of a reference cited in the topic.
Susan M. Tarlo, MB BS FRCP(C)
Professor of Medicine
University of Toronto
Respiratory Physician
Toronto Western Hospital
Toronto
Ontario
Canada
利益声明
SMT has received grant support from the Ontario Workplace Safety and Insurance Board (WSIB) and the Centre for Research Expertise in Occupational Disease (funded by Ontario Ministry of Labour). She has acted as a consultant for the Ontario Workplace Safety and Insurance Appeals Tribunal (WSIAT) and has provided clinical case assessments for WSIB. She has been a member of Task Forces for the European Academy of Allergy, Asthma and Clinical Immunology and an expert advisor to a committee of the European Respiratory Society. She is a member of the Occupational Disease Committee of the American Academy of Allergy, Asthma and Clinical Immunology (AAAAI). She has been an invited speaker at meetings of AAAAI and the American Thoracic Society. She is a coeditor of Current Opinion in Allergy and Clinical Immunology, and has received book royalties as coeditor of Asthma in the Workplace. SMT is an author of references cited in the topic.
同行评议者
Ware Kuschner, MD
Associate Professor of Medicine
Stanford University
Stanford
Staff Physician
US Department of Veterans Affairs
Palo Alto Health Care System
Palo Alto
CA
利益声明
WK declares that he has no competing interests.
Karin Pacheco, MD
Associate Professor of Medicine
National Jewish Medical Centre
Denver
CO
利益声明
KP declares that she has no competing interests.
Philip Harber, MD
Professor of Medicine
University of California
Los Angeles
CA
利益声明
PH declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Barber CM, Cullinan P, Feary J, et al. British Thoracic Society clinical statement on occupational asthma. Thorax. 2022 May;77(5):433-42.全文 摘要
Tarlo SM, Balmes J, Balkissoon R, et al. Diagnosis and management of work-related asthma: American College Of Chest Physicians Consensus statement. Chest. 2008 Sep;134(3 suppl):1S-41S. 摘要
Baur X, Sigsgaard T, Aasen TB, et al. Guidelines for the management of work-related asthma. Eur Respir J. 2012 Mar;39(3):529-45.全文 摘要
Global Initiative for Asthma (GINA). Global strategy for asthma management and prevention. May 2025 [internet publication].全文
American College of Radiology. ACR appropriateness criteria: occupational lung diseases. 2019 [internet publication].全文
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Work-exacerbated asthma
- Occupational eosinophilic bronchitis
- Coincidental nonoccupational asthma
更多 鉴别诊断Guidelines
- Global strategy for asthma management and prevention
- Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN)
更多 GuidelinesPatient information
Asthma in adults
More Patient information
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