occupational asthma

Occupational asthma is one of the most common occupational lung diseases in developed countries. This disease includes 10% of asthma in adults. Men are affected more than women. Flour and isocyanide are the most common substances that cause occupational asthma. Although the history of the patient is important, it cannot prove or disprove this type of asthma. This type of asthma may be caused by an IgE-mediated or non-IgE-mediated immunological reaction. Some substances such as isocyanide may cause this type of asthma due to several factors. The pathological changes associated with this type of asthma are similar to normal asthma and may remain in the respiratory tract for years after the end of exposure to irritants. These pathological changes can remain even if the stimulant is avoided. This disease occurs in some jobs that are more in contact with asthma triggers, such as pharmacists; Nurses;... more. in contact with agents with high molecular weight (High Molecular Weight) such as animal secretions; seafood and fish; flour; pharmaceutical products; Cleaning and cooking products and latex must pass a period of time until the patient becomes sensitive to these types of substances and IgE is secreted and asthma symptoms develop. But small molecules; Low Molecular Weight actually plays the role of a hapten that must be connected to a protein in the body to start the process. However, sometimes they cause asthma without creating IgE. These molecules include isocyanides in spray paints; plastic; covering floors; and adhesive materials, acid anhydrase: plastic materials; and dyes, cleaning agents and perfumes; Platinum salt mentioned in jewelry industry and materials used in soldering. Allergies to large IgE molecules cause this type of asthma. while small molecules are often IgE-mediated. Atopy and family history of allergy are associated with asthma caused by large molecules. But the intensity of contact with these substances is the most important determining factor in causing occupational asthma. The most common way of entering allergens is through inhalation. On the other hand, for example, in non-continuous contact with isocyanide (small molecule), occupational asthma occurs even with a small amount; Allergies to these substances have already been established. Smoking is also associated with asthma with allergens with large molecules such as coffee; caster beans; And it has crop and shame. Symptoms start a few hours after starting work and improve over the weekend. But not having such a pattern cannot rule out occupational asthma. symptoms of involvement in the upper airways such as nasal allergy; red eye; It is seen during contact with allergens (isocyanide, latex, cobalt and cleaning materials). Many triggers can also cause skin eczema. Although allergic dermatitis and urticaria cannot predict the occurrence of occupational asthma. The patient's symptoms may be normal during the visit with the doctor. Diagnosis: Asthma must be confirmed first. When spirometry is normal, the methacholine test should be used. A negative result of this test rules out occupational asthma in those who have remained in contact with irritants. In the next step, it must be proven that this asthma is caused by work. This can be done with a simple peak flow meter. 2 weeks at work and 2 weeks outside of work, the patient performs this test every day and 4 times a day. Another way is spirometry at work and outside work, which is more accurate. In mild occupational asthma, the reversibility test takes two or three days. As a result, this test can be done 2 weeks after being away from work, which becomes negative at this time, and right after returning to work, which should become positive. Otherwise, occupational asthma is ruled out. Even reducing the amount of methacholine from 16 outside work to 4 mg during work is diagnostic for a 20% decrease in FEV1. Allergy skin tests or prick tests are available for some occupational agents only. Examples of these tests include large molecules such as tree and animal proteins and small molecules such as platinum salt. An increase in sputum eosinophils of more than 2% and an increase in eNo indicates that there is asthma or eosinophilic bronchitis.