Primary, secondary, and tertiary preventive measures may reduce the incidence and severity of sensitizer-induced asthma.
Prevention of Sensitizer-Induced Occupational Asthma
- Avoid introducing predicted new sensitizing agents into the workplace (efficacy as primary prevention currently theoretical).
- Avoid use of known sensitizing agents if safer alternatives are available.
- Modify the physical or chemical form of known sensitizers to reduce risk of exposure (e.g., less volatile preparations, polymerized products, and latex gloves with a low-protein and low-powder content).
- Reduce exposure to work sensitizers by means of occupational hygiene measures (e.g., use of robotics, containment, ventilation, and respirators).
- Educate workers in the use of safe practices at work.
- Monitor and control levels of exposure to workplace sensitizers.
Secondary prevention (early detection)
- Institute medical-surveillance programs for workers at risk, consisting of preplacement and periodic respiratory questionnaires, with spirometry and immunologic tests as indicated.
- Ensure that health care providers have adequate knowledge of occupational asthma and consider it early in the evaluation of all adults with asthma symptoms, leading to early diagnosis and management of occupational asthma.
- Educate workers about the risks of occupational asthma through workplace programs, information provided by health care providers, and public-education programs (e.g., from news media, lung associations, and Web-based programs).
Tertiary prevention (appropriate treatment)
- Evaluate symptomatic workers early and obtain an accurate diagnosis.
- Remove workers from further exposure to the implicated agent after a confirmed diagnosis, when possible.
- Control other triggers and use pharmacologic measures if necessary.
- Assist the patient with a workers’ compensation claim when applicable, to limit the socioeconomic effects of the diagnosis.
- Monitor the patient’s asthma in future work locations to ensure safe placement.
- Tarlo SM, Lemiere C. Occupational asthma. N Engl J Med. 2014 Feb 13;370(7):640-9.[Medline]
- Heederik D, Henneberger PK, Redlich CA; ERS Task Force on the Management of Work-related Asthma. Primary prevention: exposure reduction, skin exposure and respiratory protection. Eur Respir Rev. 2012 Jun 1;21(124):112-24.[Medline]