Venables K M
Dept of Occupational and Environmental Medicine, University of London, UK.
Eur Respir J. 1994 Apr;7(4):768-78. doi: 10.1183/09031936.94.07040768.
This paper focuses on the prevention of asthma caused by exposure to sensitizing agents in the workplace. Control of exposure (primary prevention) is the most direct method of reducing the number of incident cases. Screening programmes are also necessary as a "safety net", and have value as secondary prevention, because early detection may improve long-term prognosis. It is recommended that regulatory or advisory bodies with responsibility for occupational asthma publish a guidance document on occupational asthma explaining their current concepts. Surveillance activities provide information on how common asthma is relative to other occupational lung diseases, and on the relative frequency of occurrence of asthma caused by different agents. Publication of a list of sensitizing agents would aid those with responsibility for control of exposure in the workplace. Epidemiological research on exposure-response relations is is necessary as a background to prevention. This paper recommends such studies. Immunotoxicological research also has a role in testing hypotheses that cannot be tested in human subjects. Some standardization of screening programmes in industry is desirable. A short symptoms questionnaire is economical and acceptable to workers, but there are other approaches. Finally, evaluative research on prevention measures gives information on their effectiveness and efficiency.
本文着重探讨工作场所接触致敏剂所致哮喘的预防。控制接触（一级预防）是减少新发病例数量的最直接方法。筛查项目作为“安全网”也是必要的，具有二级预防的价值，因为早期发现可能改善长期预后。建议负责职业性哮喘的监管或咨询机构发布一份关于职业性哮喘的指导文件，解释其当前理念。监测活动提供有关哮喘相对于其他职业性肺病的常见程度，以及不同因素所致哮喘的相对发生频率的信息。公布致敏剂清单将有助于那些负责工作场所接触控制的人员。作为预防的背景，开展接触-反应关系的流行病学研究是必要的。本文推荐此类研究。免疫毒理学研究在检验无法在人体受试者中进行测试的假设方面也发挥着作用。行业内筛查项目的某种标准化是可取的。简短的症状问卷经济实惠且工人易于接受，但也有其他方法。最后，对预防措施的评估研究可提供有关其有效性和效率的信息。
