Guidelines for Assessing and Managing Asthma Risk at Work, School, and Recreation

Abstract

Health care providers frequently are asked to advise patients with asthma about the circumstances in which they can work or pursue high-risk activities. Several national organizations have developed guidelines to aid the practitioner in addressing this task. The most widely disseminated policy statement, the Guidelines for the Diagnosis and Management of Asthma developed by the National Asthma Education and Prevention Program (NAEPP) (1, 2), focuses mainly on nonoccupational risk factors. Although a special section gives additional brief guidance on the management of occupational asthma, issues concerning what activities patients with asthma should avoid or undertake with extreme caution are not addressed. In addition to the NAEPP guidelines, there are several other consensus or policy statements on the management of asthma in various settings (3-6). Most of these focus on the pharmacologic management of asthma, either in preventing exacerbation or in rescue management. The American College of Chest Physicians (3) consensus statement takes the most comprehensive approach to workplace asthma, focusing on diagnosis and management of the sick worker, rather than preventing exacerbations in someone with preexisting asthma. Health providers need more detailed guidelines to counsel and advise individuals with asthma on how to live their lives fully, while minimizing their risk for significant illness. The specific goals of this statement are to review public health, ethical, legal, policy, and behavioral issues that impact on asthma management; develop a consensus approach to evaluating a patient with asthma considering employment in a specific workplace; outline the medical, behavioral, workplace, and management is-Members of the ad hoc statement committee have disclosed any direct commercial associations (financial relationships or legal obligations) related to the preparation of this statement. This information is kept on file at the ATS headquarters.

Respirator Use Among US Farm Operators With Asthma: Results From the 2011 Farm and Ranch Safety Survey

“…32 The American Thoracic Society advises that the use of respirators requires workers to adhere to professional guidance that includes device selection, fit testing, maintenance, and user training. 32 Patients with asthma should be encouraged to discuss respirators with their clinician.…”

“…32 The American Thoracic Society advises that the use of respirators requires workers to adhere to professional guidance that includes device selection, fit testing, maintenance, and user training. 32 Patients with asthma should be encouraged to discuss respirators with their clinician. Periodic assessment of asthma symptoms and lung function testing can help the clinician assess respirator efficacy and determine specific exposures that increase risk for adverse health effects.…”

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“…Lung function was measured with a spirometer EasyOne® model 2001 (ndd Medizintechnik AG, Zurich, Switzerland) according to American Thoracic Society (ATS) criteria [37]. The highest of three technically appropriate measurements was recorded.…”

“…The diagnosis of asthma was made according to ATS guidelines [37]. The asthmatic patients had a 6-month or longer history of recurrent chest symptoms such as coughing, dyspnea and wheezing, which were relieved by bronchodilator treatment.…”

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“…A more recent example has been marked reduction in OA caused by powdered natural rubber latex gloves in the health care industry (Allmers et al 2002; Liss and Tarlo 2001). Guidelines have recently been provided by the American Thoracic Society (2004) on managing asthma risk at work, school, and recreation that are applicable to a range of asthma-inducing agents.…”