The goal of this study was to look at all novel causes of well-documented immunologic occupational asthma (IOA) that were reported in English and French medical journals between January 2012 and mid-2014. During that time, ten novel causes of IOA were identified in case reports. Particular inhalation challenges or a combination of peak expiratory flow monitoring at and off work, confirmation of specific sensitization, and asthma were used to confirm the diagnosis. These compounds have both high and low molecular weights. Furthermore, eight investigations revealed cases of IOA caused by substances that were already recognized to be airway sensitizers, but in unique and previously unreported working settings.
There are about 400 recognized causes of IOA, and the list is constantly expanding due to the introduction of new technologies and improved physician identification of the diagnosis. All new cases involving high-molecular-weight compounds and two of the three new cases involving low-molecular-weight agents were found to have IgE-mediated sensitization. Both types of drugs were frequently linked with rhinitis symptoms. Physicians should be on the lookout for occupational asthma in any adult with new-onset or uncontrolled asthma.
