Recent developments in the field of occupational asthma research
and clinical practice are the topic of this volume. The
contribution of occupational exposures to chemical and biological
agents to the burden of asthma in adults is clearly described in an
overview of the most recent epidemiological data from both general
population and industry based studies. Emphasis is put on powerful
approaches like the use of apprentices studies, which include young
individuals, naive with regard to occupational exposures.
Diagnostic criteria for work related and work aggravated asthma are
introduced and the latest insights in underlying mechanisms are
covered as well. Specific emphasis is given to exposure response
relationships for allergen exposure, which opens opportunities for
primary and secondary prevention. Large gene-environment studies
are undertaken for asthma and their contribution to understanding
occupational asthma is discussed. Specific attention is given to
whole genome screening approaches which involve with present
technological possibilities the analysis of thousands of single
nucleotide polymorphisms, versus the more focused candidate gene
approach where genes with potential mechanistic plausibility are
considered. Although the latter approach has been used more
extensively, whole genome screening studies are becoming available
soon, also for studies on occupational asthma. Management,
prevention and surveillance are covered as well. All three areas
are undergoing some changes in perception because of the exposure
response relationships unraveled during the last decade. Diagnostic
rules are introduced to rationalize the diagnostic workup and
improve the cost benefit of surveillance schemes, and in preventive
measures at large. This approach is only recently introduced in the
field of occupational asthma and is expected to contribute even
more in the coming years. Population studies, either general
population studies, or work force based studies, have contributed
enormously to our understanding of disease etiology and in the
costs related to the disease. Issues in the design of such studies
are discussed to assist the readers in designing and conducting
their own study. Altogether this book gives a comprehensive insight
in the present developments which will change the occupational
asthma field the coming years. "
General
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