Management of patients diagnosed with occupational asthma involves several key strategies. First, early identification and referral to an occupational asthma specialist is essential to confirm diagnosis and guide management, as recommended by UK guidelines NICE NG245. Clinical history should specifically assess symptom variation related to work exposure, including improvement during periods away from work, such as holidays or weekends, to establish the occupational link NICE NG245.
Once diagnosed, the primary management strategy is to minimize or eliminate exposure to the causative occupational agent, which may require workplace modifications or removal from the exposure environment NICE NG245. This is critical to prevent progression and improve asthma control. Pharmacological treatment follows standard asthma management principles, including inhaled corticosteroids and bronchodilators, tailored to symptom control and severity NICE NG245.
Regular monitoring of asthma control is important, including symptom assessment, reliever inhaler use, and exacerbation history, with consideration of validated symptom questionnaires and fractional exhaled nitric oxide (FeNO) monitoring to guide therapy adjustments NICE NG245.
Patient education and self-management support, including a personalised asthma action plan, are integral to empower patients in managing triggers and recognizing exacerbations NICE NG245. Additionally, advice on smoking cessation and avoidance of other respiratory irritants should be provided NICE NG245.
Recent literature emphasizes the importance of a multidisciplinary approach, including occupational health input, to optimize workplace interventions and support patients in career choices to reduce future risk Moscato et al. 2009. This complements guideline recommendations by highlighting the role of occupational rhinitis as a related condition and the need for comprehensive management of upper and lower airway symptoms Moscato et al. 2009.