and Harefield NHS Foundation Trust, London, UK.
National Heart and Lung Institute, Imperial College, London, UK.
Occup Med (Lond). 2020 Jun 20;70(4):231-234. doi: 10.1093/occmed/kqaa049.
Occupational asthma (OA) is often associated with a poor prognosis and the impact of a diagnosis on an individual's career and income can be significant.
We sought to understand the consequences of a diagnosis of OA to patients attending our clinic.
Using a postal questionnaire, we surveyed all patients attending our specialist occupational lung disease clinic 1 year after having received a diagnosis of OA due to a sensitizer (n = 125). We enquired about their current health and employment status and impact of their diagnosis on various aspects of their life. Additional information was collected by review of clinical records.
We received responses from 71 (57%) patients; 77% were referred by an occupational health (OH) provider. The median duration of symptoms prior to referral was 18 months (interquartile range (IQR) 8-48). At 1 year, 79% respondents were no longer exposed to the causal agent. Whilst the unexposed patients reported an improvement in symptoms compared with those still exposed (82% versus 53%; P = 0.023), they had poorer outcomes in terms of career, income and how they felt treated by their employer; particularly those not currently employed. Almost all (>90%) of those still employed had been referred by an OH provider compared with 56% of those currently unemployed (P = 0.002)x.
The negative impact of OA on people's careers, livelihood and quality of life should not be underestimated. However, with early detection and specialist care, the prognosis is often good and particularly so for those with access to occupational health.
职业性哮喘（OA）常与预后不良有关，诊断对个体职业和收入的影响可能很大。
我们旨在了解诊断为 OA 后对来我院就诊患者的影响。
采用邮寄问卷的方式，对 125 例因致敏剂而被诊断为 OA 的患者在我院专科职业性肺部疾病门诊就诊 1 年后进行调查。我们询问了他们目前的健康和就业状况，以及诊断对他们生活各方面的影响。通过查阅临床记录收集了其他信息。
我们收到了 71 名（57%）患者的回复；77%的患者由职业健康（OH）提供者转诊。转诊前症状持续时间中位数为 18 个月（四分位间距 8-48）。1 年后，79%的患者不再接触致病因子。未暴露于致病因子的患者报告症状改善（82%比 53%；P=0.023），但在职业、收入和雇主对待他们的方式方面，他们的预后较差；尤其是那些目前未就业的患者。几乎所有（>90%）仍在工作的患者都由 OH 提供者转诊，而目前失业的患者中只有 56%（P=0.002）。
OA 对人们的职业、生计和生活质量的负面影响不应被低估。然而，通过早期发现和专科治疗，预后通常良好，特别是对于那些能够获得职业健康的患者。
