CSIM2.

90 Occupational Asthma
Features
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Within one year of new work

Latent interval of asymptomatic exposure
Evening/night time symptoms
Worsening on weekdays
Improvements during weekends/holidays
Worse with heavier exposure
Nasal/eye symptoms
Other works often affected

Importance of the correct diagnosis

Occ asthma cannot reliably be diagnosed from the history alone

Continue exposures leads to worsening and permanent asthma
Leaving work has severe financial penalties

Outcome of occupational asthma

1. Removal from exposure less than 2yr asthma usually improves/disappears
2. Removal from exposure after more than 2 yr usually persists/can be severe.
Negative workplace challenge (Challenge to test/diagnose)
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Doesnt have occupational asthma

Wasnt exposed during the test
Response was supressed by treatment
Response masked by diurnal/day to day variation?