BTS/SIGN occupational asthma guideline

Occupational asthma

• 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
• 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