Mechanisms of occupational asthma

Maestrelli, Piero; Boschetto, Pierà; Fabbri, Leonardo M.; Mapp, C. E.

doi:10.1016/j.jaci.2009.01.057

Cited by 188 publications

(160 citation statements)

References 145 publications

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“…Irritant exposures can provoke injuries to the bronchial epithelium, which would lose its protective properties [5]. An increased airway permeability caused by irritant exposures may facilitate allergens crossing the epithelium [5,18].…”

Section: Discussionmentioning

confidence: 99%

“…More than 400 agents have been recognised to cause occupational asthma, and new agents are reported each year [5,6]. Occupational asthma is classified into two different types according to the causative agents and the underlying mechanisms.…”

Section: Introductionmentioning

confidence: 99%

“…Occupational asthma is classified into two different types according to the causative agents and the underlying mechanisms. Most occupational asthmagens are low or high molecular weight sensitisers, which induce asthma through immunological mechanisms [5,7]. IgE-mediated mechanisms have been proven for most high and some low molecular weight agents [5,7].…”

Section: Introductionmentioning

confidence: 99%

“…Most occupational asthmagens are low or high molecular weight sensitisers, which induce asthma through immunological mechanisms [5,7]. IgE-mediated mechanisms have been proven for most high and some low molecular weight agents [5,7]. The second type of occupational asthma, referred to as ''nonimmunologic occupational asthma'' [5] or ''irritant induced asthma'' [8], was first described in relation to a single exposure to high concentrations of irritants.…”

Section: Introductionmentioning

confidence: 99%

“…IgE-mediated mechanisms have been proven for most high and some low molecular weight agents [5,7]. The second type of occupational asthma, referred to as ''nonimmunologic occupational asthma'' [5] or ''irritant induced asthma'' [8], was first described in relation to a single exposure to high concentrations of irritants. The potential role of repeated low-tomoderate levels of exposure to irritants in occupational asthma is receiving growing attention [8].…”

Section: Introductionmentioning

confidence: 99%

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Occupational irritants and asthma: an Estonian cross-sectional study of 34 000 adults

Dumas

Laurent

Bousquet

et al. 2014

European Respiratory Journal

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Occupational exposures make important contributions to asthma morbidity. The role of low/ moderate level irritant exposures remains unclear. We aimed to determine which occupational exposures are associated with asthma in an eastern European country with low asthma prevalence.The Estonian Genome Center of University of Tartu collected data from 50 077 adults in 2002-2011. Asthma was assessed through a questionnaire regarding diagnosed diseases, current health status and medication. Exposures to 22 agents during the current and longest held jobs were estimated using an asthma-specific job-exposure matrix.Analyses included 34 015 subjects (aged 18-65 years, 67.0% females), of which 1209 (3.6%) reported asthma (608 with physician-confirmed diagnosis). After adjusting for age, sex and smoking habits, lifetime occupational exposure to known asthmagens (20.4%) was significantly associated with physician-diagnosed asthma (OR 1.28, 95% CI 1.03-1.59), especially high molecular weight agents (flour: OR 2.36, 95% CI 1.31-4.27; animals: OR 1.62, 95% CI 1.00-2.60). Exposure to low/moderate levels of irritants (17.4%) was associated with physician-diagnosed asthma (OR 1.88, 95% CI 1.48-2.37). More pronounced associations were observed in subjects reporting current treated asthma.Beyond confirming the effect of known asthmagens (which are well-known, mostly from observations in western countries), the results provide evidence for a role of low/moderate exposure to irritants. This finding, observed in a country with a low prevalence of asthma and atopy, provides new insight into the understanding of asthma heterogeneity. @ERSpublications Increased asthma risk was associated with occupational exposure to moderate levels of irritants in an Estonian study

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%