Defining and investigating occupational asthma

a consensus approach

C. Francis, C. O. Prys-Picard, D. Fishwick, C. Stenton, P. S. Burge, L. M. Bradshaw, Jonathan Geoffrey Ayres, M. Campbell, R. McL Niven

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Background: At present there is no internationally agreed definition of occupational asthma and there is a lack of guidance regarding the resources that should be readily available to physicians running specialist occupational asthma services.

Aims: To agree a working definition of occupational asthma and to develop a framework of resources necessary to run a specialist occupational asthma clinic.

Method: A modified RAND appropriateness method was used to gain a consensus of opinion from an expert panel of clinicians running specialist occupational asthma clinics in the UK.

Results: Consensus was reached over 10 terms defining occupational asthma including: occupational asthma is defined as asthma induced by exposure in the working environment to airborne dusts vapours or fumes, with or without pre-existing asthma; occupational asthma encompasses the terms "sensitiser-induced asthma'' and "acute irritant-induced asthma'' ( reactive airways dysfunction syndrome ( RADS)); acute irritant-induced asthma is a type of occupational asthma where there is no latency and no immunological sensitisation and should only be used when a single high exposure has occurred; and the term "work-related asthma'' can be used to include occupational asthma, acute irritant-induced asthma ( RADS) and aggravation of pre-existing asthma. Disagreement arose on whether low dose irritant-induced asthma existed, but the panel agreed that if it did exist they would include it in the definition of "work-related asthma''. The panel agreed on a set of 18 resources which should be available to a specialist occupational asthma service. These included pre-bronchodilator FEV1 and FVC (% predicted); peak flow monitoring ( and plotting of results, OASYS II analysis); non-specific provocation challenge in the laboratory and specific IgE to a wide variety of occupational agents.

Conclusion: It is hoped that the outcome of this process will improve uniformity of definition and investigation of occupational asthma across the UK.

Original languageEnglish
Pages (from-to)361-365
Number of pages5
JournalOccupational and Environmental Medicine
Volume64
Issue number6
DOIs
Publication statusPublished - Jun 2007

Keywords

  • quality indicators
  • care

Cite this

Francis, C., Prys-Picard, C. O., Fishwick, D., Stenton, C., Burge, P. S., Bradshaw, L. M., ... Niven, R. M. (2007). Defining and investigating occupational asthma: a consensus approach. Occupational and Environmental Medicine, 64(6), 361-365. https://doi.org/10.1136/oem.2006.028902

Defining and investigating occupational asthma : a consensus approach. / Francis, C.; Prys-Picard, C. O.; Fishwick, D.; Stenton, C.; Burge, P. S.; Bradshaw, L. M.; Ayres, Jonathan Geoffrey; Campbell, M.; Niven, R. McL.

In: Occupational and Environmental Medicine, Vol. 64, No. 6, 06.2007, p. 361-365.

Research output: Contribution to journalArticle

Francis, C, Prys-Picard, CO, Fishwick, D, Stenton, C, Burge, PS, Bradshaw, LM, Ayres, JG, Campbell, M & Niven, RM 2007, 'Defining and investigating occupational asthma: a consensus approach', Occupational and Environmental Medicine, vol. 64, no. 6, pp. 361-365. https://doi.org/10.1136/oem.2006.028902
Francis C, Prys-Picard CO, Fishwick D, Stenton C, Burge PS, Bradshaw LM et al. Defining and investigating occupational asthma: a consensus approach. Occupational and Environmental Medicine. 2007 Jun;64(6):361-365. https://doi.org/10.1136/oem.2006.028902
Francis, C. ; Prys-Picard, C. O. ; Fishwick, D. ; Stenton, C. ; Burge, P. S. ; Bradshaw, L. M. ; Ayres, Jonathan Geoffrey ; Campbell, M. ; Niven, R. McL. / Defining and investigating occupational asthma : a consensus approach. In: Occupational and Environmental Medicine. 2007 ; Vol. 64, No. 6. pp. 361-365.
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