Prognosis

Sensitiser-induced occupational asthma (OA)

Very low-quality evidence suggests that 4 years after removal from exposure to the causal agent, the likelihood of reporting absence from asthma symptoms, or improvement in asthma symptoms, increases significantly compared with continued exposure (risk ratio 4.80 and 2.47, respectively).[90] Approximately 25% to 30% of OA patients removed from exposure can expect to make a full recovery; an additional 30% to 35% will report a reduction in symptoms.​[90][22]​​​ Much of the improvement occurs within the first 2 years following cessation of exposure.​[22]​ Removal from exposure (but not reduction of exposure) may improve lung function compared with continued exposure.[90]​ 

The likelihood of improvement or resolution of symptoms is greater in those workers who have relatively normal lung function, and shorter duration of symptoms, at the time of diagnosis.[22]​​[94]​ The medical prognosis is worse for those who continue to work with exposure to the causative agent.​​

Socioeconomic factors

Patients may experience significant psychosocioeconomic impacts, especially if they cannot be accommodated by the same employer in an unexposed work area.[91][92][99]​ These impacts may occur despite support from workers' compensation systems.

The small proportion of patients who may be near retirement and cannot find another job, and who elect to continue working in the same company with respiratory protective devices and asthma drugs, should have their asthma closely monitored and should be further strongly advised to leave the work exposure if their asthma is not controlled.[36][71]

Irritant-induced OA

OA may clear after months to years but has been reported to persist in some patients for several years.[100] Careful monitoring on return to work is important to identify and manage any subsequent work-exacerbated asthma.[36][71]

Short-term asthma control and severity may be worse in patients with irritant-induced OA than sensitiser-induced OA.[101]

Use of this content is subject to our disclaimer