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Open AccessReview

Causes and Phenotypes of Work-Related Asthma

Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, 35128 Padova, Italy
Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505-2888, USA
Toronto Western Hospital, University Health Network, St. Michael’s Hospital and University of Toronto, Toronto, ON M5G 2P1, Canada
Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(13), 4713;
Received: 26 May 2020 / Revised: 24 June 2020 / Accepted: 28 June 2020 / Published: 30 June 2020
(This article belongs to the Special Issue Occupational Exposure and Non-malignant Respiratory Disease)
Work-related asthma (WRA) includes heterogeneous conditions, which have in common (i) symptoms and signs compatible with asthma and (ii) a relationship with exposures in the workplace. The types of WRA described in this review are distinguished by their etiology, comprising of work-exacerbated asthma (WEA), irritant-induced asthma (IIA), and immunologic occupational asthma (OA). There have been significant advances in the definition and characterization of the different forms of WRA by international panels of experts. The present review provides a comprehensive and updated view of the current knowledge on causes and phenotypes of WRA. Health care practitioners should consider WRA in any case of adult asthma, given that one fifth of workers with asthma report symptoms of WEA and it has been estimated that OA represents 10% to 25% of asthma in adulthood. The information provided in this review will facilitate the physician in the recognition of the different forms of WRA, since it has been established that five categories of agents are responsible for at least 60% of WEA cases and seven groups of agents are the cause of 70% of immunologic OA. In addition, there is agreement that IIA can be elicited not only by a single massive irritant exposure, but also by low/moderate repeated irritant exposures. View Full-Text
Keywords: occupational disease; exposure; workplace; prevention; respiratory system occupational disease; exposure; workplace; prevention; respiratory system
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Maestrelli, P.; Henneberger, P.K.; Tarlo, S.; Mason, P.; Boschetto, P. Causes and Phenotypes of Work-Related Asthma. Int. J. Environ. Res. Public Health 2020, 17, 4713.

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