This project was to improve understanding of emerging occupational respiratory conditions typified by chronic cough and airway eosinophilia. Chronic cough is associated with impaired quality of life and eosinophilic airway disorders may be associated with accelerated lung function decline. It is clear from the case reports that workplace allergens may induce cough-variant asthma and non-asthmatic eosinophilic bronchitis. These conditions may be more difficult to recognise as being occupational in nature given that by definition they lack some of the classical symptoms of asthma and the most common diagnostic tests may be normal. Patients with these conditions usually present with an isolated chronic and work-related cough. Cough-variant asthma may be confirmed with work-related changes in airway responsiveness. Eosinophilic bronchitis can only be confirmed by measuring sputum eosinophils. In the UK access to this type of physiological testing is limited to a small number of specialist centres. These tests may not form part of the routine diagnostic protocol and reliance on peak flow testing is likely to miss patients with cough-variant asthma and eosinophilic bronchitis. The recognition of these diseases may offer an opportunity to modify allergen exposures early, which is likely to improve prognosis for affected workers.
This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusions expressed, are those of the authors alone and do not necessarily reflect HSE policy.
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