Occupational asthma guidance emphasises importance of health screening

A new clinical statement on occupational asthma emphasises the importance of health surveillance and prompt specialist referral of workers who have new asthma symptoms or abnormal lung function.

The British Thoracic Society’s (BTS) clinical statement, published in the Thorax journal, outlines what health practitioners need to know about occupational asthma and best practice for its diagnosis and treatment.

Occupational exposures account for around one in six cases of asthma in working age adults. Those who experience occupational asthma face increased risk of unemployment and being diagnosed with other conditions including depression and anxiety.

Around 25–30% of occupational asthma patients who permanently cease exposure to the allergens causing their asthma will make a full recovery, and another 30–35% will report a reduction in symptoms with treatment.

The statement says that workers should be referred to an occupational asthma specialist if workplace screening identifies new asthma symptoms or abnormal lung function.

Health practitioners who encounter employees who report new asthmatic symptoms or are less able to control their asthma effectively should ask them about their job and whether there symptoms are better or worse on days away from work. Those in high-risk roles and those who report improvement away from work should be referred to a specialist occupational lung disease specialist.

It says clinicians should work in partnership with patients to develop a personalised management plan that balances long-term health and employment outcomes.

Dr Chris Barber, chair of the clinical statement group at BTS said: “Being in work is important for a number of reasons, not just to provide a source of income, but also to provide people with purpose, social interaction, structure and identity. Unfortunately, for many patients, the diagnosis of allergic occupational asthma is delayed, adversely affecting asthma severity and increasing the risk of unemployment.

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“If spotted early enough, some patients can effectively be cured, if workplace adaptations can be made that completely prevent further exposure to the cause – early referral to a specialist centre offers patients the best chance of a good outcome.

“This clinical statement provides healthcare workers with simple guidance on how to screen patients with asthma for a possible occupational cause, aiming to reduce diagnostic delays in primary and secondary care.”