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      Asma ocupacional. Serie de casos Translated title: Occupational asthma. Report cases

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          Abstract

          Resumen Antecedentes: El asma tiene una prevalencia mundial de 18 %. En el asma relacionada con el trabajo existe asociación entre asma y exposición a polvo, vapores o humos exclusivamente en el ambiente laboral, en pacientes con o sin diagnóstico previo de asma; representa aproximadamente de 5 a 25 % de los casos de asma de inicio en edad adulta. En México existe escasa información al respecto. Casos clínicos: Se reporta una serie de 17 pacientes con diagnóstico de asma y exposición laboral a polvo, vapores o humos; se determinó asma ocupacional por parte del Servicio del Alergia e Inmunología Clínica, Hospital de Especialidades, Centro Médico Nacional Siglo XXI. Conclusiones: La salud en el trabajo es primordial para el adecuado desempeño del personal, el funcionamiento óptimo de la unidad laboral y para evitar daños a la salud, pérdidas económicas y repercusiones sociales. La función del médico a cargo de la salud ocupacional en cuanto a la prevención, diagnóstico y manejo oportuno de patologías frecuentes de acuerdo con el sector laboral representa una gran área de oportunidad en centros de trabajo que es importante atender.

          Translated abstract

          Abstract Background: Asthma has a global prevalence of 18%. In work-related asthma, there is an association between asthma and the exposure to dust, vapors, or fumes only at the workplace, in patients with or without a previous asthma diagnosis; it represents approximately 5-25% of the cases of adult onset asthma. In Mexico, the information about this topic is scarce. Cases report: A series of 17 patients with an asthma diagnosis and occupational exposure to dust, vapors, or fumes is reported; occupational asthma was determined by the Allergy and Clinical Immunology Service at Centro Médico Nacional Siglo XXI. Conclusions: Occupational health is essential for the proper performance of the staff, the optimal performance of the work unit, and for avoiding health damages, economic losses, and social implications. The role of the physician in charge of occupational health in terms of prevention, diagnosis, and timely management of frequent pathologies according to the work sector, represents a great area of opportunity that is important to fulfill in many work centers.

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          Most cited references10

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          Guidelines for the management of work-related asthma.

          Work-related asthma, which includes occupational asthma and work-aggravated asthma, has become one of the most prevalent occupational lung diseases. These guidelines aim to upgrade occupational health standards, contribute importantly to transnational legal harmonisation and reduce the high socio-economic burden caused by this disorder. A systematic literature search related to five key questions was performed: diagnostics; risk factors; outcome of management options; medical screening and surveillance; controlling exposure for primary prevention. Each of the 1,329 retrieved papers was reviewed by two experts, followed by Scottish Intercollegiate Guidelines Network grading, and formulation of statements graded according to the Royal College of General Practitioners' three-star system. Recommendations were made on the basis of the evidence-based statements, which comprise the following major evidence-based strategic points. 1) A comprehensive diagnostic approach considering the individual specific aspects is recommended. 2) Early recognition and diagnosis is necessary for timely and appropriate preventative measures. 3) A stratified medical screening strategy and surveillance programme should be applied to at-risk workers. 4) Whenever possible, removing exposure to the causative agent should be achieved, as it leads to the best health outcome. If this is not possible, reduction is the second best option, whereas respirators are of limited value. 5) Exposure elimination should be the preferred primary prevention approach.
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            EAACI position paper: irritant-induced asthma.

            The term irritant-induced (occupational) asthma (IIA) has been used to denote various clinical forms of asthma related to irritant exposure at work. The causal relationship between irritant exposure(s) and the development of asthma can be substantiated by the temporal association between the onset of asthma symptoms and a single or multiple high-level exposure(s) to irritants, whereas this relationship can only be inferred from epidemiological data for workers chronically exposed to moderate levels of irritants. Accordingly, the following clinical phenotypes should be distinguished within the wide spectrum of irritant-related asthma: (i) definite IIA, that is acute-onset IIA characterized by the rapid onset of asthma within a few hours after a single exposure to very high levels of irritant substances; (ii) probable IIA, that is asthma that develops in workers with multiple symptomatic high-level exposures to irritants; and (iii) possible IIA, that is asthma occurring with a delayed-onset after chronic exposure to moderate levels of irritants. This document prepared by a panel of experts summarizes our current knowledge on the diagnostic approach, epidemiology, pathophysiology, and management of the various phenotypes of IIA.
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              Are high- and low-molecular-weight sensitizing agents associated with different clinical phenotypes of occupational asthma?

              High-molecular-weight (HMW) proteins and low-molecular-weight (LMW) chemicals can cause occupational asthma (OA) although few studies have thoroughly compared the clinical, physiological, and inflammatory patterns associated with these different types of agents. The aim of this study was to determine whether OA induced by HMW and LMW agents shows distinct phenotypic profiles.
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                Author and article information

                Journal
                ram
                Revista alergia México
                Rev. alerg. Méx.
                Colegio Mexicano de Inmunología Clínica y Alergia, A.C. (Ciudad de México, Ciudad de México, Mexico )
                2448-9190
                September 2020
                : 67
                : 3
                : 286-292
                Affiliations
                [3] Ciudad de México orgnameInstituto Mexicano del Seguro Social orgdiv1Hospital General de Zona 30 orgdiv2División de Salud en el Trabajo Mexico
                [1] Ciudad de México orgnameInstituto Mexicano del Seguro Social orgdiv1Centro Médico Nacional Siglo XXI orgdiv2Hospital Especialidades Mexico
                [2] Ciudad de México orgnameInstituto Mexicano del Seguro Social orgdiv1Hospital General de Zona 32 orgdiv2Coordinación de Evaluación de salud en el Trabajo Mexico
                Article
                S2448-91902020000300286 S2448-9190(20)06700300286
                10.29262/ram.v67i3.794
                d539eecd-dec6-498a-a570-fdc823ebe8e2

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 28 July 2020
                : 17 June 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 7
                Product

                SciELO Mexico

                Categories
                Casos clínicos

                Disfunción reactiva de la vía aérea,Asma ocupacional,Asma en adultos,Reactive airway dysfunction,Occupational asthma,Asthma in adults

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