Division of Occupational and Environmental Medicine, University of California, San Francisco, CA, USA,
Curr Allergy Asthma Rep. 2014 Apr;14(4):425. doi: 10.1007/s11882-014-0425-9.
The upper airway (extending from the nares to larynx) fulfills essential physiologic functions, including sensation, air conditioning, filtration, and communication. As the portal of entry for the respiratory tract, the upper airway's sentinel function is performed by the olfactory and trigeminal nerves. Sensory (eye, nose and throat) irritation figures prominently in symptom reporting in so-called "problem buildings," as well as in industrial exposures to irritant gases, vapors, and smokes. Both irritants and allergens can alter function in the upper airway, leading to loss of air conditioning and filtering due to airflow obstruction and hypersecretion. Increasing evidence points to a "unified airway" model of pathogenesis (in which rhinitis may precede the development of asthma). The spectrum of occupational irritant- and allergen-related upper airway health effects-including sensory irritation, olfactory dysfunction, rhinitis, sinusitis, nasal septal perforation, and sinonasal cancer-is reviewed in this article.
上呼吸道（从鼻腔延伸到喉部）具有重要的生理功能，包括感觉、空气调节、过滤和交流。作为呼吸道的入口，上呼吸道的哨兵功能由嗅觉和三叉神经执行。在所谓的“问题建筑”以及刺激性气体、蒸气和烟雾的工业暴露中，感官（眼睛、鼻子和喉咙）刺激在症状报告中占据重要地位。刺激物和过敏原都可以改变上呼吸道的功能，导致气流阻塞和过度分泌导致空气调节和过滤功能丧失。越来越多的证据表明，发病机制存在“统一气道”模型（其中鼻炎可能先于哮喘的发展）。本文综述了职业性刺激物和过敏原相关上呼吸道健康影响的范围，包括感觉刺激、嗅觉功能障碍、鼻炎、鼻窦炎、鼻中隔穿孔和鼻旁窦癌。
