Brooks S M
J Allergy Clin Immunol. 1982 Jul;70(1):56-66. doi: 10.1016/0091-6749(82)90202-0.
Occupational immunologic lung disease can be identified both in the individual patient under laboratory conditions and in a population of workers in industry. Occupational airways disorder is the most common occupational immunologic pulmonary process and is a disease of the airways caused by the inhalation of a substance or material that the worker manufactures or uses directly or that is incidentally present at the worksite. There are several occupational airways disorders, including industrial bronchitis, occupational asthma, and reactive airways disease syndrome, the latter two of which will be discussed more thoroughly. Occupational asthma can be appropriately identified when the following are present (1) typical symptoms, i.e., wheeze, cough, shortness of breath, and/or chest tightness; (2) specific identification of the offending agent; (3) documentation that the agent can cause asthma; (4) wheezes on physical examination; (5) pulmonary function changes; (6) immunologic abnormalities; (7) airway hyperreactivity; and (8) positive bronchial challenge with specific material. The diagnosis of occupational airways disorder requires a comprehensive approach, including clinical history, physiologic measurements, immunologic testing, and identification of airway hyperreactivity. By this approach both individual subjects and working populations can be studied.
职业性免疫性肺病既可以在实验室条件下对个体患者进行识别，也可以在工业领域的工人群体中进行识别。职业性气道疾病是最常见的职业性免疫性肺部疾病，是一种因吸入工人直接生产或使用的物质或材料，或工作场所偶然存在的物质而导致的气道疾病。职业性气道疾病有多种，包括工业性支气管炎、职业性哮喘和反应性气道疾病综合征，后两者将进行更深入的讨论。当出现以下情况时，可恰当识别职业性哮喘：（1）典型症状，即喘息、咳嗽、呼吸急促和/或胸闷；（2）明确确定致病因素；（3）有文件证明该因素可导致哮喘；（4）体格检查时有喘息；（5）肺功能改变；（6）免疫异常；（7）气道高反应性；（8）对特定物质支气管激发试验呈阳性。职业性气道疾病的诊断需要综合方法，包括临床病史、生理测量、免疫检测以及气道高反应性的识别。通过这种方法，可以对个体受试者和工作人群进行研究。
