Occupational Asthma and Respiratory Health

Occupational asthma represents a significant subset of adult‐onset asthma, arising from workplace exposures to sensitising or irritant agents. It combines immunological and non‐immunological mechanisms, with clinical manifestations ranging from intermittent cough and wheeze to chronic airflow limitation and heightened bronchial hyperresponsiveness. Common high‐molecular‐weight sensitising agents include flour dust, animal proteins and latex, while low‐molecular‐weight sensitising chemicals encompass isocyanates, persulphates and certain metals. Irritant‐induced asthma may develop without a latency period after single high‐level exposures or following repeated lower‐level exposures to substances such as chlorine, ammonia and acid mists. The global burden of work‐related asthma remains high in both developed and low‐income settings, with disparities influenced by socio-economic status, regulatory frameworks and occupational hygiene practices. Early recognition through structured clinical histories, objective lung function testing and exposure assessment is vital to prevent progression. Effective control strategies combine exposure reduction, substitution of hazardous agents, implementation of engineering controls, personal protective equipment and ongoing medical surveillance. Interdisciplinary collaboration among clinicians, industrial hygienists and policy makers is essential to translate research findings into practical interventions and to reduce the societal impact of occupational respiratory disease.

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Occupational Asthma and Respiratory Health publication trend

The graph below shows the total number of articles in occupational asthma and respiratory health across all publications each year (not limited to Nature Index journals).

Technical terms

Occupational asthma: Asthma caused by exposure to agents in the workplace, encompassing both immunological and irritant mechanisms.

Sensitiser-induced asthma: A form of occupational asthma that develops after a latency period during which the immune system becomes sensitised to a specific high- or low-molecular-weight agent.

Irritant-induced asthma: Airway inflammation and bronchoconstriction triggered by acute high-level or repeated lower-level exposure to non-sensitising irritant substances, without prior sensitisation.

Asthmagen: A chemical or biological agent capable of inducing asthma through sensitisation or direct airway irritation.

Bronchial hyperresponsiveness: An exaggerated bronchoconstrictive response to various stimuli, characteristic of asthma and measured by methacholine or histamine challenge tests.

Peak expiratory flow (PEF): The maximum speed of expiration, used in serial monitoring to detect work-related changes in airway function.

Job-exposure matrix (JEM): A structured tool linking job titles or tasks with estimated exposure levels to hazardous substances, facilitating epidemiological assessment.

References

1. Global patterns of asthma burden related to environmental risk factors during 1990–2019: an age-period-cohort analysis for global burden of disease study 2019. Environmental Health (2024).
2. Association of Occupational Exposure to Disinfectants With Incidence of Chronic Obstructive Pulmonary Disease Among US Female Nurses. JAMA Network Open (2019).
3. Causes and Phenotypes of Work-Related Asthma. International Journal of Environmental Research and Public Health (2020).