- In patients with adult onset, or reappearance of childhood asthma, healthcare professionals should consider that there may be an occupational cause
- Adults with airflow obstruction should be asked:
- are you better on days away from work?
- are you better on holiday?
- Those with positive answers should be investigated for occupational asthma
- In suspected work-related asthma, the diagnosis of asthma should be confirmed using standard objective criteria
- Objective diagnosis of occupational asthma should be made using serial peak flow measurements, with at least four readings per day
- Skin-prick testing or tests for specific IgE should be used in the investigation of occupational asthma caused by high molecular weight agents
- Skin-prick testing or tests for specific IgE should not be used in the investigationof occupational asthma caused by low molecular weight agents.
- A single measurement of non-specific reactivity should not be used
for the validation of occupational asthma
- Relocation away from exposure should occur as soon as diagnosis is
confirmed, and ideally within 12 months of the first work-related
symptoms of asthma
Work-related asthma and rhinitis: case finding and management in primary care
full guidelines available from...
British Thoracic Society, Scottish Intercollegiate Guidelines Network. British guideline on the management of asthma. September 2016. Updated 2019.
Reproduced with kind permission from SIGN.