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Occupational exposure and asthma

2018; Elsevier BV; Volume: 120; Issue: 5 Linguagem: Inglês

10.1016/j.anai.2018.03.026

1534-4436

Anh Dao, David I. Bernstein,

Contact Dermatitis and Allergies

Key Messages•Adult-onset asthma occurring as a direct result of occupational exposure (OA) is a common occurrence.•Asthma caused by other factors (eg, 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 (eg, employers).InstructionsCredit can now be obtained, free for a limited time, by reading the review article and completing all activity components. Please note the instructions listed below:•Review the target audience, learning objectives and all disclosures.•Complete the pre-test.•Read the article and reflect on all content as to how it may be applicable to your practice.•Complete the post-test/evaluation and claim credit earned. At this time, physicians will have earned up to 1.0 AMA PRA Category 1 CreditTM. Minimum passing score on the post-test is 70%. Overall PurposeParticipants will be able to demonstrate increased knowledge of the clinical treatment of allergy/asthma/immunology and how new information can be applied to their own practices. Learning ObjectivesAt the conclusion of this activity, participants should be able to:•Describe the different clinical presentations of work-related asthma.•Evaluate a patient with suspected occupational asthma using the most appropriate diagnostic test.•Integrate occupational history as part of routine evaluation of working patients with asthma and/or rhinitis.Release Date: May 1, 2018Expiration Date: April 30, 2020 Target AudiencePhysicians involved in providing patient care in the field of allergy/asthma/immunology AccreditationThe American College of Allergy, Asthma & Immunology (ACAAI) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. DesignationThe American College of Allergy, Asthma & Immunology (ACAAI) designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Disclosure PolicyAs required by the Accreditation Council for Continuing Medical Education (ACCME) and in accordance with the American College of Allergy, Asthma and Immunology (ACAAI) policy, all CME planners, presenters, moderators, authors, reviewers, and other individuals in a position to control and/or influence the content of an activity must disclose all relevant financial relationships with any commercial interest that have occurred within the past 12 months. All identified conflicts of interest must be resolved and the educational content thoroughly vetted for fair balance, scientific objectivity, and appropriateness of patient care recommendations. It is required that disclosure be provided to the learners prior to the start of the activity. Individuals with no relevant financial relationships must also inform the learners that no relevant financial relationships exist. Learners must also be informed when off-label, experimental/investigational uses of drugs or devices are discussed in an educational activity or included in related materials. Disclosure in no way implies that the information presented is biased or of lesser quality. It is incumbent upon course participants to be aware of these factors in interpreting the program contents and evaluating recommendations. Moreover, expressed views do not necessarily reflect the opinions of ACAAI. Disclosure of Relevant Financial RelationshipsAll identified conflicts of interest have been resolved. Any unapproved/investigative uses of therapeutic agents/devices discussed are appropriately noted. Planning Committee•Jonathan A. Bernstein, MD (Annals CME Subcommittee): Consultant, Fees: Imedics; Consultant/Principal Investigator, Grants/Fees: Boehringer Ingelheim, GlaxoSmithKline; Consultant/Principal Investigator/Speaker, Grants/Fees: AstraZeneca, CSL Behring, Novartis/Genentech, Shire; Speaker, Fees: Baxalta•Guha Krishnaswamy, MD (Annals CME Subcommittee): Clinical Research, Grant: CSL Behring•Gailen D. Marshall, Jr, MD, PhD (Editor-in-Chief): Clinical Research, Grants: Sanofi, Stallergenes•Anna Nowak-Wegrzyn, MD (CME Series Editor, Deputy Editor): Clinical Research, Grant: Nutricia, Nestle, ITN NIH, DBV, Astellas; Speaker, Fees: Nutricia, Nestle, Thermofisher; Contributor, Royalties: UpToDate: Clinical Trial DMC Member: Merck; Board Member: Gerber, IFPIES•John J. Oppenheimer, MD (Annals CME Subcommittee, Associate Editor): Consultant, Other financial gains: DBV Technologies, GlaxoSmithKline, Kaleo; Clinical Research, Grants: AstraZeneca, Boehringer Ingelheim, Novartis AuthorThe following individuals have no relevant financial relationships to disclose:•Anh Dao, MD•David I. Bernstein, MDRecognition of Commercial Support: This activity has not received external commercial support.Copyright Statement: ©2015-2018 ACAAI. All rights reserved.CME Inquiries: Contact the American College of Allergy, Asthma & Immunology at [email protected]or 847-427-1200. •Adult-onset asthma occurring as a direct result of occupational exposure (OA) is a common occurrence.•Asthma caused by other factors (eg, 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 (eg, employers). Credit can now be obtained, free for a limited time, by reading the review article and completing all activity components. Please note the instructions listed below:•Review the target audience, learning objectives and all disclosures.•Complete the pre-test.•Read the article and reflect on all content as to how it may be applicable to your practice.•Complete the post-test/evaluation and claim credit earned. At this time, physicians will have earned up to 1.0 AMA PRA Category 1 CreditTM. Minimum passing score on the post-test is 70%. Participants will be able to demonstrate increased knowledge of the clinical treatment of allergy/asthma/immunology and how new information can be applied to their own practices. At the conclusion of this activity, participants should be able to:•Describe the different clinical presentations of work-related asthma.•Evaluate a patient with suspected occupational asthma using the most appropriate diagnostic test.•Integrate occupational history as part of routine evaluation of working patients with asthma and/or rhinitis. Release Date: May 1, 2018 Expiration Date: April 30, 2020 Physicians involved in providing patient care in the field of allergy/asthma/immunology The American College of Allergy, Asthma & Immunology (ACAAI) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American College of Allergy, Asthma & Immunology (ACAAI) designates this journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. As required by the Accreditation Council for Continuing Medical Education (ACCME) and in accordance with the American College of Allergy, Asthma and Immunology (ACAAI) policy, all CME planners, presenters, moderators, authors, reviewers, and other individuals in a position to control and/or influence the content of an activity must disclose all relevant financial relationships with any commercial interest that have occurred within the past 12 months. All identified conflicts of interest must be resolved and the educational content thoroughly vetted for fair balance, scientific objectivity, and appropriateness of patient care recommendations. It is required that disclosure be provided to the learners prior to the start of the activity. Individuals with no relevant financial relationships must also inform the learners that no relevant financial relationships exist. Learners must also be informed when off-label, experimental/investigational uses of drugs or devices are discussed in an educational activity or included in related materials. Disclosure in no way implies that the information presented is biased or of lesser quality. It is incumbent upon course participants to be aware of these factors in interpreting the program contents and evaluating recommendations. Moreover, expressed views do not necessarily reflect the opinions of ACAAI. All identified conflicts of interest have been resolved. Any unapproved/investigative uses of therapeutic agents/devices discussed are appropriately noted. •Jonathan A. Bernstein, MD (Annals CME Subcommittee): Consultant, Fees: Imedics; Consultant/Principal Investigator, Grants/Fees: Boehringer Ingelheim, GlaxoSmithKline; Consultant/Principal Investigator/Speaker, Grants/Fees: AstraZeneca, CSL Behring, Novartis/Genentech, Shire; Speaker, Fees: Baxalta•Guha Krishnaswamy, MD (Annals CME Subcommittee): Clinical Research, Grant: CSL Behring•Gailen D. Marshall, Jr, MD, PhD (Editor-in-Chief): Clinical Research, Grants: Sanofi, Stallergenes•Anna Nowak-Wegrzyn, MD (CME Series Editor, Deputy Editor): Clinical Research, Grant: Nutricia, Nestle, ITN NIH, DBV, Astellas; Speaker, Fees: Nutricia, Nestle, Thermofisher; Contributor, Royalties: UpToDate: Clinical Trial DMC Member: Merck; Board Member: Gerber, IFPIES•John J. Oppenheimer, MD (Annals CME Subcommittee, Associate Editor): Consultant, Other financial gains: DBV Technologies, GlaxoSmithKline, Kaleo; Clinical Research, Grants: AstraZeneca, Boehringer Ingelheim, Novartis The following individuals have no relevant financial relationships to disclose:•Anh Dao, MD•David I. Bernstein, MD Recognition of Commercial Support: This activity has not received external commercial support. Copyright Statement: ©2015-2018 ACAAI. All rights reserved. CME Inquiries: Contact the American College of Allergy, Asthma & Immunology at [email protected] or 847-427-1200.