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Title: Many Cases Of Asthma May Be Due To Workplace Chemicals
URL: http://www.pslgroup.com/dg/2864E.htm
Doctor's Guide
May 16, 1997


LONDON -- May 16, 1997 -- As many as one in five cases of asthma may be due to exposure to chemicals in the workplace, write two occupational health experts in this week's The Lancet.

"The diagnosis of occupational asthma should be considered in every case of adult-onset asthma or worsening asthma in adult life," write Katherine Venables of the National Heart and Lung Institute, London, UK, and Moira Chan-Yeung of the University of British Columbia in Vancouver, Canada.

Asthma is a disease in which inflammation and spasm in the bronchi (airways) impedes the movement of air in and out of the lung. The symptoms of asthma may vary from mild wheezing and cough to severe shortness of breath. In some cases, asthma can be so severe that it causes respiratory arrest. "Occupational asthma is a potentially fatal condition," the two researchers warn.

Roughly 250 chemicals have been found to cause occupational asthma. Grain dust, for example, has caused asthma in grain-store workers; henna in hairdressers; coffee beans in coffee roasters; flour in bakers; penicillin in pharmacists and health-care workers; cobalt dust in metal grinders; and oil mists in tool setters.

In cases, occupational asthma is caused by an allergic immune reaction to a specific substance, but irritating chemicals, gases, and fumes can act directly on and damage bronchi, triggering what is called irritant-induced asthma.

Occupational asthma usually appears soon after a worker is first exposed to the asthma-inducting chemical, but sometimes it may appear months to years later, write Venables and Chan-Yeung.

"The total duration of exposure, the duration of symptoms, and the severity of asthma at the time of diagnosis are important determinants of outcome," they write. "Early diagnosis and early withdrawal from exposure are the keys to complete recovery. Patients who remain in the same job and continue to be exposed to the same causal agent after diagnosis worsen with time."

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