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Occupational Medicine 2005 55(8):588-594; doi:10.1093/occmed/kqi182
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© The Author 2005. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

IN-DEPTH REVIEW

Prevention of occupational asthma—practical implications for occupational physicians

Susan M. Tarlo1,2,3,4 and Gary M. Liss2,3

1 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
2 Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
3 Gage Occupational and Environmental Health Unit, College Street, Toronto, Ontario, Canada
4 Division of Respiratory Medicine, Toronto Western Hospital, East Wing 7-449, 399 Bathurst Street, Toronto, Ontario, Canada

Background Occupational factors have been estimated to contribute to ~10% of adult-onset asthma and occupational asthma (OA) is one of the most common occupational lung diseases in industrialized areas. Persistent asthma frequently occurs with significant socio-economic impacts.

Methods A literature search was performed using PubMed. The key term searched was occupational asthma combined with prevention.

Results Primary prevention has been effective for OA related to natural rubber latex, and may have reduced the incidence of diisocyanate-induced asthma. Medical health surveillance has been effective in settings such as the detergent enzyme industry, workers exposed to complex platinum salts and likely for diisocyanate workers in Ontario. Tertiary prevention is still required for workers with OA and can improve prognosis.

Conclusions OA is potentially preventable. Sufficient studies have demonstrated the rationale and benefit of primary preventive strategies. Medical health surveillance programs combined with occupational hygiene measures and worker education have been associated with improved outcomes but further studies are needed to understand the optimum frequency and measures for such programs and to identify the separate contribution of the components. Until primary and secondary prevention is better understood and implemented, there will also remain a need for tertiary preventive measures.

Keywords      Medical surveillance; occupational asthma; prevention

Correspondence to: Susan M. Tarlo, Division of Respiratory Medicine, Toronto Western Hospital, East Wing 7-449, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada. Tel: +1 416 603 5177; fax: +1 416 603 6763; e-mail: susan.tarlo{at}utoronto.ca


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