An Official American Thoracic Society Statement: Work-Exacerbated Asthma
An Official American Thoracic Society Statement: Work-Exacerbated Asthma
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DOI：
10.1164/rccm.812011st
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发表时间：
2011-08-01
影响因子：
24.7
通讯作者：
Toren, Kjell
中科院分区：
文献类型：
--
作者：
Henneberger, Paul K.;Redlich, Carrie A.;Toren, Kjell
理由：职业暴露可导致哮喘发作和加重。然而，与工作引起的职业性哮喘（OA）相比，工作加重型哮喘（WEA）受到的关注较少。目的：本声明的目的是总结目前关于WEA的描述性流行病学、临床特征、管理和治疗的知识;提出WEA的病例定义;并讨论预防和研究的需求。方法：关于WEA的信息主要通过医学文献的系统检索确定。关于预防和研究需求的声明达成了共识。测量和主要结果：WEA被定义为由于工作条件导致的哮喘恶化。WEA很常见，成人哮喘患者的中位患病率为21.5%。不同类型的药物或工作条件可能会加剧哮喘。具有持续性工作相关症状的WEA病例可能具有与OA病例相似的临床特征（严重程度，药物需求）和不良社会经济后果（失业，收入减少）。与与工作无关的哮喘成年人相比，WEA病例报告的症状天数更多，寻求更多的医疗护理，生活质量较低。WEA应考虑在任何哮喘患者，是越来越严重或谁有工作相关的症状。WEA的管理应侧重于减少工作暴露和优化标准的医疗管理，只有当这些措施是不成功的，在工作中的变化，结论：WEA是一个共同的和公认的不良后果造成的工作条件。需要进行更多的研究，以提高对WEA的风险因素、机制和结果的理解，并为预防性干预措施提供信息和评估。
Rationale: Occupational exposures can contribute to the exacerbation as well as the onset of asthma. However, work-exacerbated asthma (WEA) has received less attention than occupational asthma (OA) that is caused by work.Objectives: The purpose of this Statement is to summarize current knowledge about the descriptive epidemiology, clinical characteristics, and management and treatment of WEA; propose a case definition for WEA; and discuss needs for prevention and research.Methods: Information about WEA was identified primarily by systematic searches of the medical literature. Statements about prevention and research needs were reached by consensus.Measurements and Main Results: WEA is defined as the worsening of asthma due to conditions at work. WEA is common, with a median prevalence of 21.5% among adults with asthma. Different types of agents or conditions at work may exacerbate asthma. WEA cases with persistent work-related symptoms can have clinical characteristics (level of severity, medication needs) and adverse socioeconomic outcomes (unemployment, reduction in income) similar to those of OA cases. Compared with adults with asthma unrelated to work, WEA cases report more days with symptoms, seek more medical care, and have a lower quality of life. WEA should be considered in any patient with asthma that is getting worse or who has work-related symptoms. Management of WEA should focus on reducing work exposures and optimizing standard medical management, with a change in jobs only if these measures are not successful.Conclusions: WEA is a common and under recognized adverse outcome resulting from conditions at work. Additional research is needed to improve the understanding of the risk factors for, and mechanisms and outcomes of, WEA, and to inform and evaluate preventive interventions.