Occupational respiratory diseases. Merchant JA, Bochlecke BA, Taylor G, eds. Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 86-102, 1986 Sep; :461-477
Occupational asthmas and rhinitis are reviewed with respect to causative agents, relevant occupations and workers at risk, epidemiology, pathology, clinical description and diagnostic criteria, methods of prevention, and research needs. Agents associated with the development of occupational asthma and rhinitis are described as being both natural (plant and animal origin) and synthetic (including metal salts, diisocyanates, anhydrides, amines, pharmaceuticals, and miscellaneous organic products). Populations at risk include persons involved in printing, paper manufacturing, grain handling, lumber and woodworking, animal contact, detergent manufacturing, vegetable processing, cosmetology, electronics, leatherworking, platinum refining, metal plating, fur dying, painting, plastics and rubber manufacture as well as foundry, insulation, hospital, laboratory, pharmaceutical, and farm workers. Studies of sensitization have shown that the atopic segment of the population is at greater risk of sensitization than the nonatopic. Tests appropriate for the diagnosis of occupational asthma and rhinitis include pulmonary function studies, bronchial provocation tests, chest roentgenograms, skin tests, and the radio allergosorbent test. Suggested methods of prevention include recognition of sensitizers in the workplace, possible preemployment screening to determine atopic status, exposure monitoring, evaluation of pre and post shift pulmonary function tests to determine early sensitization, and relocation of the sensitized worker to minimize exposure.