Version June 2024
| Evaluation |
| Potential for workplace-related symptoms: |
| Recognized sensitizers (eg, isocyanates, plant or animal products). |
| Irritants* or physical stimuli (eg, cold/heat, dust, humidity). |
| Coworkers may have similar symptoms. |
| Patterns of symptoms (in relation to work exposures): |
| Improvement occurs during vacations or days off (may take a week or more). |
| Symptoms may be immediate (<1 hour), delayed (most commonly, 2-8 hours after exposure), or nocturnal. |
| Initial symptoms may occur after high-level exposure (eg, spill). |
| Documentation of work-relatedness of airflow limitation: |
| Serial charting for 2-3 weeks (2 weeks at work and up to 1 week off work, as needed to identify or exclude work-related changes in PEF): |
| Record when symptoms and exposures occur. |
| Record when a bronchodilator is used. |
| Measure and record peak flow (or FEV1) every 2 hours while awake. |
| Immunologic tests. |
| Referral for further confirmatory evaluation (eg, bronchial challenges). |
| Management |
| Work-aggravated asthma: |
| Work with onsite health care providers or managers/supervisors. |
| Discuss avoidance, ventilation, respiratory protection, tobacco smoke-free environment. |
| Occupationally induced asthma: |
| Recommend complete cessation of exposure to initiating agent. |
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