According to the severity of the clinical course, specialists distinguish three variants of the disease. With a mild course, asthma attacks rarely occur (1-2 times per month), last from several minutes to half an hour, and are usually easily removed by taking tablets (theofedrine, aminophylline) or even hot tea. Respiratory difficulties in the form of shortness of breath appear with moderate or significant physical exertion. Timely cessation of contact with a professional allergen, as a rule, is accompanied by recovery. In the interictal period, the condition of patients is usually satisfactory.
The moderate severity of the course of the disease is characterized by the appearance of asthma attacks 2-3 times a week for up to one hour, passing through injections of drugs that expand the bronchi (e.g., aminophylline) or their aerosol inhalations. In the interictal period, patients periodically experience whistling and wheezing in the chest, moderate breathing difficulties. Deterioration is observed with slight physical exertion. Discontinuation of contact with a professional allergen is accompanied by a significant improvement, and typical asthmatic attacks cease, although periodic minor or mild shortness of breath and cough remain.
A severe course is accompanied by the appearance of frequent (often daily) attacks of suffocation, up to the development of a life-threatening condition. Shortness of breath appears with little physical exertion. To obtain a therapeutic effect, it is often necessary to use hormonal drugs – glucocorticoids (prednisone, becotide). The cessation of contact with the industrial allergen no longer causes a noticeable improvement in the patient’s condition.
Diagnosis of primary occupational bronchial asthma is based on a combination of the following three points: 1) the absence of allergic diseases before entering work ; 2) the characteristic course of the disease (contact with allergens in the workplace, typical symptoms); 3) confirmation by laboratory diagnostics or allergological tests of hypersensitivity to industrial allergens.
Diagnosis of secondary occupational bronchial asthma is based on an analysis of the course of the disease. If the onset of asthmatic attacks was preceded by long-existing dust or asthmatic bronchitis, asthma attacks began to appear against the background of exacerbations of bronchitis, this is a good argument in favor of establishing a professional cause of the disease.
If professional bronchial asthma is detected, even in the mildest version, immediate removal of the patient from contact with industrial allergens is required. Failure to comply with this rule threatens the rapid and severe progression of pathology with lifelong disability of the patient.
Allergens have a multilateral harmful effect. In addition to allergic diseases, they can provoke the occurrence of oncological diseases, intoxications, dysbiosis, etc. Therefore, for each substance with an allergenic effect, based on its specific characteristics, its own scheme of medical examination of workers in contact with it is established. In most cases, examinations of a therapist, otolaryngologist, dermatologist are indicated. Patients suffering from any allergic diseases (even if indicated in the past) should not be allowed to work with industrial allergens.