Allergens in Occupational Allergy: Prevention and Management – Focus on Asthma

This article reviews the main aspects for the prevention and management of occupational asthma due to allergic sensitization in the workplace. An accurate allergen identification and characterization is the essential aspect of the primary prevention. Both high and low molecular weight molecules (the first acting as complete antigens the second as haptens) can induce asthma. Sensitization is a dose-related phenomenon, therefore the lower the exposure the lower the risk of sensitization. Health surveillance is the key action of the secondary prevention; it aims at the early identification of workers with occupational exposure to asthma-causing agents by means of respiratory questionnaires; preplacement and periodic visits, with spirometry; immunologic tests; and further investigations to confirm diagnosis and then remove the person from further exposure. Asthma management may be identified with the tertiary prevention. In this phase other than the pharmacological treatment, the occupational doctor should remove the worker from the exposure, as the reduction of allergens is a negative prognostic factor for a severe decline of lung function. In any case, workers should be informed on the risk they encounter at work for a better outcome of the preventive measures.