21 Assessment of job-related asthma cases: our three-year experience

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IntroductionWork-related asthma (WRA) is one of the most common occupational diseases. There is no reliable statistical data for WRA in Turkey. In this study, we aimed to review diagnosing procedures and the characteristics of patients who were diagnosed with WRA at our clinic.MethodsGlobal Initiative for Asthma guideline was used to establish the diagnosis of asthma. Spirometric measurement, reversibility test and BPT were performed according to ATS criteria.Detailed occupational history was gained with questioning the job(s) starting from the first job, used material(s), duration, time, place properties chronologically and extensively. The relation of the complaints with job was defined. PEF measurements were performed for at least four times, for at least two weeks in working environment and at least two weeks during resting period. A graphic was createdusing the Microsoft Office Excel program taking the highest measurement of daily four sessions into account separately for resting and working periods. The PEF assessment graphic and job history were interpreted as; compatible with OA, compatible with WEA and technically not approved.ResultTwo hundred and fourteen patients admitted to our clinic with WRA suspicion between November 2013 and June 2016. They were referred by an occupational health specialist, personal application, second- or third-line chest disease specialists [61 (28%), 51 (23%), and 102 (47%) respectively]. Fifty-four patients (25%) were diagnosed with occupational asthma (OA), and 24 (11%) with work exacerbated asthma (WEA), total 78 workers diagnosed with WRA. Twenty five (32,1%) had allergic rhinitis. The most commonly used test were PEF monitoring and BPT respectively.DiscussionPEF monitoring, non-specific BPT and skin prick test for suitable cases would be sufficient besides occupational history and clinical properties for the diagnosis of WRA. PEF assessment, one of the most important tests for the diagnosis of WRA, must be performed.

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