Accepted: 20 January 2018
Occupational rhinitis and occupational asthma: Association
Rahmat A. Balogun DO, MS, MPH
Andrea Siracusa MD
Dennis Shusterman MD, MPH
Division of Occupational and Environmental
Medicine, University of California, San
(Formerly) University of Perugia, Perugia,
Dennis Shusterman, MD, MPH, Upper Airway
Biology Laboratory, 1301 South 46th Street,
Building 112 Richmond, CA 94804.
Background: Occupational asthma is the most frequently reported occupational
respiratory disease in registries, and is often co-diagnosed with occupational rhinitis.
We undertook a systematic review of the English-language epidemiologic literature
linking these two conditions, with emphasis on progression from occupational rhinitis
to occupational asthma.
Methods: PubMed and Embase were queried in a series of structured searches
designed to identify studies comparing occupational asthma and occupational rhinitis
incidence or prevalence in occupationally exposed individuals.
Results: The searches yielded a total of 109 unique citations, 15 of which yielded
inferential data on the occupational rhinitis-asthma relationship. Nine of fifteen studies
showed statistically significant associations between the occurrence of occupational
rhinitis and occupational asthma among individual workers.
Conclusions: Limited data support the notion that occupational rhinitis precedes the
development of occupational asthma, particularly when high-molecular-weight
(HMW) agents are involved. The relationship between the two conditions could not
be evaluated in many relevant studies due to a lack of cross-tabulation of individual
epidemiology, occupational asthma, occupational rhinitis, specific inhalation challenge, united
Occupational asthma, according to existing national workplace
health surveillance systems, has been the most commonly reported
occupational respiratory disease in both the United States and Great
Britain for more than two decades.
Occupational asthma is
defined as “...work-related asthma characterized by variable airflow
obstruction, airway hyperresponsiveness, and airway inflammation
attributable to a particular exposure in the workplace and not due to
stimuli encountered outside the workplace.”
As distinguished from
work-exacerbated asthma (in which workplace factors act as a
trigger for pre-existing asthma), occupational asthma arises de novo
in the workplace, either due to specific (“allergic”) sensitization to
workplace agents (“occupational asthma with latency”)orasa
nonspecific consequence of exposure to airborne irritant chemicals
(“occupational asthma without latency”/“irritant-induced asthma”).
Specific sensitization, in turn, can occur to either high molecular
Institution at which work was performed: University of California, San Francisco, CA.
Am J Ind Med. 2018;61:293–307. wileyonlinelibrary.com/journal/ajim © 2018 Wiley Periodicals, Inc.