Occupational asthma
Rüegger, M.
Schweizerische Rundschau für Medizin Praxis 80(40): 1054-1057
1991
ISSN/ISBN: 1013-2058 PMID: 1925233 Document Number: 368194
The recognition of bronchial asthma as occupational disease is essentially a matter of legislation and not of medical definitions. Swiss law accepts an occupational nature of asthma when its causes derive to more than 50% from the work place. Causes are extremely diverse, whereby in Europe flour (bakers) and isocyanates (spray lacquers) dominate. Together, these causative agents contribute close to 50% of all cases of occupational asthma. The clinical picture is that of classic bronchial asthma. Peculiarities are seen only regarding the temporal dependence between exposition and beginning of airway obstruction. Regarding diagnosis of occupational asthma the following questions should be answered. 1. Is the dyspnea described by the patient real bronchial asthma? 2. Is there a documented temporal connection between exposition and complaints? 3. Is there a causative agent at the work place? Peak-flow measurements are particularly useful for documentation of connection of symptoms with occupation. They demand, however, a certain degree of cooperation by the patient. The prime therapeutic measure is avoidance of further contacts with the responsible agent. The Swiss health authorities (SUVA) have the power to issue decisions of unsuitability for certain workplaces or exposures. Such a measure is however severe and requires therefore a careful diagnosis and an evaluation of risk and benefit for the patient.