D2.428 - Asthma severity and work exposure in 66 patient reffered to occupational and allergy unit

Work-related asthma accounts for 15-20% of adult asthma cases. Occupational asthma can be severe and is a significant risk factor for work-related disability. Early diagnosis and appropriate management are essential to prevent disease progression and associated disability.

We studied 66 patients diagnosed with asthma and rhinitis, with a mean age of 47 years (SD = ±18.4), referred to our occupational and allergy unit. Of the participants, 34 (51.5%) were female. At the time of the visit, 37 patients (56%) were non-smokers, 14 (21%) were smokers, and 15 (23%) were ex-smokers. Atopy was present in 83.3% (n=55) of the patients.

Based on exposure to potential occupational asthma and/or rhinitis causal agents, patients were divided into three groups: 27 (41%) patients with no history of exposure, 26 (39.4%) employed in household tasks and activities with highly probable or certain exposure to chemical agents commonly found in cleaning products, and 13 (19.6%) with professional exposure to industrial pollutants (e.g., heavy metals).

The distribution of asthma severity was as follows: intermittent in 1 patient (1.5%), mild persistent in 24 (36.4%), moderate persistent in 37 (56.1%), and moderate-severe persistent in 4 (6.1%). Allergic rhinitis was present in 52 patients (78.8%). Rhinitis severity was as follows: intermittent in 2 patients (3%), mild persistent in 20 (30.3%), moderate persistent in 38 (57.6%), and severe in 1 patient (1.5%). Of the 66 patients, 37 (56%) were polysensitized to common allergens, 13 (19.7%) were sensitized to trees, 2 (3%) were sensitized to both common and occupational allergens, and 11 (16.7%) were non-atopic.Work-related rhinitis was more common in workers exposed to industrial pollutants (38.5%) compared to other groups (14.8% and 3.8%), p = 0.018. Similarly, work-related asthma was more frequent in patients with moderate-severe persistent asthma (26.8%) compared to those with intermittent and mild persistent asthma (4%), p = 0.023. The mean BMI was significantly higher in patients with moderate-severe persistent asthma (28.7, SD 5) compared to those with intermittent and mild persistent asthma (23.9, SD 4.7), p<0.05.

In conclusion, our study highlights the impact of work-related exposures on the severity of asthma and rhinitis in a real-world setting. To effectively manage asthma and rhinitis and prevent disease progression and disability in asthmatic patients, work-related exposure should be considered in the treatment plan.