Asma relacionada con el trabajo
Resumen
Asma Relacionada con el Trabajo (ART) es el asma cuyos síntomas y/o estudios de función pulmonar o inflamación bronquial tienen relación con la exposición laboral. Incluye Asma Ocupacional (AO) y Asma Agravada por el Trabajo (AAT).
El AO es el asma cuyas causas son únicamente atribuibles a un determinado ambiente laboral y no se hallan fuera del mismo. Se divide en dos grupos:
1) AO Inmunológica, asma inducida por sensibilización a agentes específicos en el medio laboral a través de un mecanismo asociado a una respuesta inmunológica específica.
2) AO No Inmunológica o por irritantes, producida por un mecanismo irritativo o toxico, con dos formas de presentación.
El AAT es aquella situación en la que se constata empeoramiento del asma, ya sea de inicio anterior o concomitante al del trabajo y como consecuencia de una exposición ambiental en el lugar de trabajo.
Las herramientas del diagnóstico del AO son: 1) una buena historia clínica-laboral; 2) Pruebas Inmunológicas: Pruebas cutáneas y métodos in Vitro; 3) Monitorización del pico de Flujo (PEF) como primer paso para relacionar la exposición laboral con medidas de función pulmonar; 4) Determinación de la Hiperrespuesta Bronquial Inespecífica (HRBI), medida que confirma el asma y cuya determinación seriada en periodo de exposición y no exposición puede diagnosticar el AO; 5) Determinación de la Hiperrespuesta Bronquial Específica, prueba oro del diagnóstico del AO.
La demora diagnóstica se asocia con peor pronóstico por lo que se deben de realizar esfuerzos para diagnosticar con prontitud el asma ocupacional.Referencias
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