[Occupational asthma: current state of the problem].

Abstract

Occupational asthma is a disease with serious medical, social and economical consequences. Most patients have to change their jobs and very often they lose their professional qualification. This article gives a current review of the problems of occupational bronchial asthma and allergic rhinitis in the region of Eastern Bohemia. The results obtained are compared with the situation in the whole Czech Republic and in the world. The number of new cases of occupational asthma and allergic rhinitis discovered in the contact area of the Department of Occupational Medicine at the University Hospital in Hradec Králové fluctuates around 15-20 cases per year, and 80-100 new cases are reported in the whole republic. The rate of occupational asthma and occupational allergic rhinitis of the total asthma and rhinitis incidence in the Czech population fluctuates between 5-15%. Regarding the number of affected employees, flour is considered the most important allergen. Other important noxas include agricultural allergens, textile dust, diisocyanates and disinfectious preparations. The importance of the alergogenius effect of natural rubber latex and diisocyanates has increased in occupational medicine mainly in the last 20 years. Regarding latex, its harmful effect has been especially demonstrated in health providers who wear protective latex gloves, which results not only in contact eczema-dermatitis, but also in bronchial asthma and allergic rhinitis. Diisocyanates, highly reactive and aggressive substances, originate during polyurethane production which has a wide industrial application (production of polyurethane foam and rubber, paints, adhesives, injected substances, glues, varnishes etc.). The incidence of occupational asthma diseases in workers exposed to diisocyanates is high. Typically, a development of the disease begins after a short time exposure. In this thesis, a diagnostic method in suspected occupational allergic disease of the airways is suggested and possibilities for the application of particular diagnostic methods are given with emphasis on their advantages and limitations and the necessity to determine a proper diagnostic method for the individual patient. In searching for a particular cause of the occupational disease a significant benefit is the determination of a wide range of specific Ig E class serum antigens, in case IgG and standardization of the method provoke tests for its practical application.