What are the recommended management strategies for patients diagnosed with occupational asthma?

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 ¹. 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 ¹.

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 ¹. 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 ¹.

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 ¹.

Patient education and self-management support, including a personalised asthma action plan, are integral to empower patients in managing triggers and recognizing exacerbations ¹. Additionally, advice on smoking cessation and avoidance of other respiratory irritants should be provided ¹.

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).