Abstract
We would like to make a comment regarding the management of occupational asthma as discussed in the useful State of the Art article on this topic by Mapp and colleagues (1). Based on our clinical experience in a busy urban occupational medicine clinic, patients with occupational asthma—not just those with work-aggravated asthma—continue to progressively react to nonspecific airborne environmental triggers that differ from their original exposure(s), especially in cases when recognition of disease is made late in the course of their disease. Studies in the medical literature have shown that concomitant sensitization to ubiquitous allergens is frequent in subjects with sensitizerinduced occupational asthma (2) and that occupational asthmatics continue to present persistent symptoms and nonspecific bronchial reactivity for extensive periods of time after diagnosis (3–19 yr), even while away from work (3). Recognition of this is important to encourage appropriate reassignment to different work settings that prevent worsening of disease severity and allow continued gainful employment.
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