Gautier C, Lecam M T, Basses S, Pairon J C, Andujar P
Centre hospitalier intercommunal de Créteil, service de pathologies professionnelles et de l'environnement, 94000 Créteil, France.
Centre hospitalier intercommunal de Créteil, service de pathologies professionnelles et de l'environnement, 94000 Créteil, France; INSERM, unité 955, équipe 4, 94000 Créteil, France; Université Paris-Est Créteil, faculté de santé, 94000 Créteil, France.
Rev Mal Respir. 2021 Nov;38(9):914-935. doi: 10.1016/j.rmr.2021.09.006. Epub 2021 Oct 25.
Work-related asthma (WRA) accounts for 10-25% of all adult asthma. It therefore seems important to raise questions regarding an asthmatic's approach to occupational or job training activities. WRA takes on two forms: work-exacerbated asthma (WEA) and occupational asthma (OA), which encompasses different subtypes of heterogeneous mechanisms. It currently represents a major challenge for occupational medicine in terms of detailed diagnosis, social care, the economic repercussions for workers and employers and, last but not least, social insurance. This review aims to sensitize health care practitioners to the peculiarities of WRA management in routine practice. More specifically, prognosis depends on early diagnosis, medical care and work adjustment measures. WEA and OA are explained in detail in view of identifying causative agents and at-risk occupations and defining adapted medical strategy. Relevant lines of questioning and complementary exams are presented. In addition, the key role of the occupational physician, especially as regards recognition and identification of occupational disease, is underlined, the objective being to facilitate optimal professional and social management. In future studies, the key role of counseling and orientation mechanisms should be highlighted as means of preventing WRA occurrence.
职业性哮喘（WRA）占所有成人哮喘病例的10%-25%。因此，针对哮喘患者对待职业或职业培训活动的方式提出一些问题似乎很重要。职业性哮喘有两种形式：工作加重性哮喘（WEA）和职业性哮喘（OA），后者包含不同亚型的异质性机制。目前，在详细诊断、社会护理、对工人和雇主的经济影响，以及最后但同样重要的社会保险方面，它对职业医学构成了重大挑战。本综述旨在提高医疗从业者对日常实践中职业性哮喘管理特殊性的认识。更具体地说，预后取决于早期诊断、医疗护理和工作调整措施。鉴于确定致病因素和高危职业并定义适应性医疗策略，对工作加重性哮喘和职业性哮喘进行了详细解释。还介绍了相关的询问思路和补充检查。此外，强调了职业医生的关键作用，特别是在职业病的识别和认定方面，目的是促进最佳的职业和社会管理。在未来的研究中，应突出咨询和指导机制作为预防职业性哮喘发生手段的关键作用。
