Dept of Environmental Medicine and Public Health, University of Padova, Padua, Italy.
Eur Respir Rev. 2012 Jun 1;21(124):88-96. doi: 10.1183/09059180.00004811.
The outcome of occupational asthma after diagnosis is often poor. The identification of factors associated with a worse outcome may help in the management of the disease, determining its prognosis and assessing the permanent impairment attributable to occupational exposure. The aim of this systematic review was to provide the available evidence from the medical literature to answer the question: "What is the contribution of host factors and workplace exposure to the risk of a bad outcome of occupational asthma?" A systematic literature search was conducted in March 2010. We retrieved 177 abstracts. Of these, 67 were assessed as potentially relevant. After full text evaluation, 35 articles that were actually relevant for the question were included in the analysis. The information obtained was sufficient to establish that older age, high-molecular-weight agents, impaired lung function and longer duration of exposure to the offending agent at the time of diagnosis had a negative role on the outcome of occupational asthma. Atopy and smoking at diagnosis did not seem to influence the outcome of occupational asthma. A limited number of studies considered sex and the pattern of asthmatic reaction on specific inhalation challenge and their findings were contradictory.
职业性哮喘的诊断后结果通常较差。识别与较差结果相关的因素可能有助于疾病的管理，确定其预后，并评估因职业暴露而导致的永久性损害。本系统评价的目的是从医学文献中提供现有证据，以回答以下问题：“宿主因素和工作场所暴露对职业性哮喘不良结局的风险有何贡献？” 2010 年 3 月进行了系统的文献检索。我们检索到 177 个摘要。其中，67 个被评估为潜在相关。经过全文评估，有 35 篇文章实际上与该问题相关，被纳入分析。所获得的信息足以确定，年龄较大、高分子量物质、肺功能受损以及在诊断时接触致病物质的时间较长，对职业性哮喘的结果有负面影响。在诊断时的特应性和吸烟似乎并不影响职业性哮喘的结果。少数研究考虑了性别和特定吸入性挑战的哮喘反应模式，其结果相互矛盾。
