Rosenman K D, Beckett W S
Michigan State University, 909 Fee Hall, Room 117 West Fee, East Lansing, MI 48824, USA.
Department of Medicine, Mount Auburn Hospital, Cambridge, MA, USA; Harvard Medical School, USA.
Respir Med. 2015 May;109(5):625-31. doi: 10.1016/j.rmed.2015.03.004. Epub 2015 Mar 31.
Work-related asthma is common and yet remains a challenge to diagnose. Access to a listing of agents associated with work-related asthma has been suggested as useful in assisting in the diagnosis.
The Association of Occupational and Environmental Clinics (AOEC) developed criteria that were used to review the peer-reviewed medical literature published in English. Based on this review, substances were designated either as a sensitizing agent or an irritant. The reviews were conducted by a board certified internist/pulmonologist/occupational medicine specialist from 2002 to 2007 and a board certified internist/occupational medicine physician from 2008- date. All reviews were then reviewed by the nine member AOEC board of directors.
The original list of agents associated with new onset work-related asthma was derived from the tables of a text book on work-related asthma. After 13 years of review, there are 327 substances designated as asthma agents on the AOEC list; 173 (52.9%) coded as sensitizers, 35 (10.7%) as generally recognized as an asthma causing agent, four (1.2%) as irritants, two (0.6%) as both a sensitizer and an irritant and 113(34.6%) agents that still need to be reviewed.
The AOEC has developed a readily available web based listing of agents associated with new onset work-related asthma in adults. The listing is based on peer-reviewed criteria. The listing is updated twice a year. Regular review of the peer-reviewed medical literature is conducted to determine whether new substances should be added to the list. Clinicians should find the list useful when considering the diagnosis of work-related asthma.
职业性哮喘很常见，但诊断仍具有挑战性。获取与职业性哮喘相关的致病因子清单有助于辅助诊断。
职业与环境诊所协会（AOEC）制定了标准，用于回顾以英文发表的经同行评审的医学文献。基于该回顾，物质被指定为致敏剂或刺激物。回顾工作由一名2002年至2007年的董事会认证内科医生/肺科医生/职业医学专家以及一名2008年至今的董事会认证内科医生/职业医学医师进行。所有回顾随后由AOEC的九名成员董事会进行审核。
与新发职业性哮喘相关的原始致病因子清单源自一本职业性哮喘教科书的表格。经过13年的回顾，AOEC清单上有327种物质被指定为哮喘致病因子；173种（52.9%）被编码为致敏剂，35种（10.7%）被普遍认为是导致哮喘的致病因子，4种（1.2%）为刺激物，2种（0.6%）既是致敏剂又是刺激物，113种（34.6%）致病因子仍需审核。
AOEC已编制了一份易于获取的基于网络的与成人新发职业性哮喘相关的致病因子清单。该清单基于同行评审标准。清单每年更新两次。定期对经同行评审的医学文献进行回顾，以确定是否应将新物质添加到清单中。临床医生在考虑职业性哮喘的诊断时应会发现该清单很有用。
