Anh Dao MD David I Bernstein MD Ann Allergy Asthma Immunol May 2018120 468475 Occupational Exposure and Asthma Key Messages Adultonset asthma occurring as a direct result of occupational exposure OA is a common occurrence ID: 935728
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Slide1
Slide2Occupational Exposure and Asthma
Anh Dao, MD
David I. Bernstein, MD
Ann
Allergy Asthma Immunol.
May
2018;120
:468-475
Slide3Occupational Exposure and Asthma
Key
Messages
Adult-onset asthma occurring as a direct result of occupational exposure (OA) is a common occurrence.
Asthma caused by other factors
(e.g. seasonal allergic asthma) can be triggered by different occupational exposures and is known as work-related asthma (WRA).The number of occupational exposures that can adversely impact WRA is vast, varied, and sometimes initially vague.Identifying the specific occupational agents that affect WRA must be approached methodically with careful history, appropriate examination, and testing (laboratory, skin prick) as indicated to develop focused interventional strategies.Recognizing and mitigating asthma-exacerbating factors in the workplace requires cooperation and coordination among patient, allergist, and occupational representatives (e.g. employers).
Dao A, Bernstein DI.
Ann Allergy Asthma Immunol.
May
2018;120
:468-475
Slide4Stepwise Approach to Evaluating the Worker with Work-related Lower Respiratory Symptoms
Dao A, Bernstein DI.
Ann Allergy Asthma Immunol.
May
2018;120:468-475
Slide5Environmental Exposure to Peanut and the
Risk of an Allergic Reaction
Matthew Greenhawt, MD, MBA, MSc
Ann
Allergy Asthma Immunol.
May
2018;120
:476-481
Slide6Environmental Exposure to Peanut and the
Risk of an Allergic Reaction
Key Messages
Greenhawt M. Ann
Allergy Asthma Immunol.
May 2018;120:476-481Data have shown that peanut butter vapors and smeared peanut butter on skin do not cause systemic reactions; that peanut can be abated from hands and surfaces using appropriate cleaning agents; and that shelled peanut dust does not become airborne.Recent data have suggested that a dose of 1.5 mg of peanut protein would be generally tolerated by approximately 95% of the peanut-allergic population based on objective symptoms in challenge-based studies.
Restrictive
policies that focus on bans (or restricted presence in certain areas) of peanuts or peanut-containing products in
environments such
as schools or on commercial aircraft are not backed by evidence that such measures work.
Slide7Model of Air Circulation in a Passenger Cabin
Greenhawt M. Ann
Allergy Asthma Immunol.
May
2018;120:476-481
Slide8Passenger Effects of Airflow from Routine
Cabin Movement
Greenhawt M. Ann
Allergy Asthma Immunol.
May
2018;120:476-481
Slide9School Exposure and Asthma
Brittany Esty, MD
Wanda Phipatanakul, MD, MS
Ann
Allergy Asthma Immunol.
May
2018;120
:482-487
Slide10School Exposure and Asthma
Key Messages
The indoor school environment is a significant reservoir of allergens, molds, pollutants, and endotoxin.
There
is an association between school exposure and pediatric asthma morbidity.
School
-based interventions have the potential for substantial individual, community, and public health benefit.
Ongoing
research is needed to study the health effects associated with school exposures and assess cost-effectiveness of
multifaceted school
-based interventions.
Esty B, Phipatanakul W. Ann
Allergy Asthma Immunol.
May
2018;120
:482-487
Slide11Hormones, Sex, and Asthma
Jeffrey A. Yung, BA
Hubaida Fuseini, BS
Dawn C. Newcomb, PhD
Ann
Allergy Asthma Immunol.
May
2018;120
:488-494
Slide12Hormones, Sex, and Asthma
Key Messages
Clinical, epidemiological, and animal studies suggest that sex hormones are important in regulating asthma pathogenesis.
A
gender disparity exists in asthma and switches at puberty from boys having the highest prevalence as children to women
having the highest prevalence as adults.Many women with asthma report changes in their symptoms throughout the menstrual cycle, during pregnancy, and in menopause.Estrogen signaling promotes and androgen signaling attenuates type 2-mediated allergic airway inflammation in mice.Ovarian hormones are important for interleukin-17A–mediated, neutrophilic airway inflammation in mice.
Yung JA, et al
.
Ann Allergy Asthma Immunol.
May
2018;120
:488-494
Slide13Schematic of Allergen-mediated Type 2, Interleukin (IL)–17A–mediated,
and
Interferon-
g
(IFN-g)–mediated PathwaysYung JA, et al. Ann Allergy Asthma Immunol. May 2018;120:488-494