Malo Jean-Luc, Lemière Catherine, Gautrin Denyse, Labrecque Manon
Department of Chest Medicine, Hôpital du Sacré-Coeur de Montréal, Canada.
Curr Opin Pulm Med. 2004 Jan;10(1):57-61. doi: 10.1097/00063198-200401000-00010.
The scientific literature on occupational asthma is steadily increasing and no longer only describes case reports with prevalence figures and limited physiopathologic and immunologic data. Prospective cohort studies are currently carried out with relevant incidence figures and risk factors. Genetic susceptibility is explored. New diagnostic means are described. Surveillance programs are conducted and preventive measures are proposed.
A relevant account was published on the respiratory consequences (irritant-induced asthma, a type of occupational asthma) of exposure of firefighters at the World Trade Center site. Glutathione-S-transferase appears to be an interesting susceptibility gene for occupational asthma as a result of isocyanates. Inflammation caused by neutrophils and not only by eosinophils is more often associated with occupational asthma. Examination of induced sputum and assessment of exhaled nitric oxide are becoming useful diagnostic tools. Cleaners are at increased risk of developing occupational asthma, although the causal agents are unknown. Surveillance programs currently combine strategies that aim to reduce exposure and identify cases early.
New scientific information provides better, accurate figures on the frequency of occupational asthma and on risk factors, proposes relevant diagnostic tools more directly related to the physiopathology of the disease, and suggests effective surveillance programs in high-risk workplaces.
关于职业性哮喘的科学文献在不断增加，不再仅仅描述患病率数据有限且生理病理和免疫学资料有限的病例报告。目前正在开展前瞻性队列研究，得出了相关发病率数据和危险因素。对遗传易感性进行了探索。描述了新的诊断方法。开展了监测项目并提出了预防措施。
发表了一篇关于世贸中心遗址消防员接触后呼吸后果（刺激性物质诱发的哮喘，一种职业性哮喘）的相关报告。谷胱甘肽 - S - 转移酶似乎是异氰酸酯导致职业性哮喘的一个有趣的易感基因。与职业性哮喘相关的炎症更多是由中性粒细胞而非仅由嗜酸性粒细胞引起。诱导痰检查和呼出一氧化氮评估正成为有用的诊断工具。清洁工患职业性哮喘的风险增加，尽管致病因素尚不清楚。目前的监测项目结合了旨在减少接触和早期识别病例的策略。
新的科学信息提供了关于职业性哮喘发病率和危险因素的更准确数据，提出了与该疾病生理病理更直接相关的有用诊断工具，并在高风险工作场所提出了有效的监测项目。
