Is occupational asthma caused by low-molecular-weight chemicals associated with contact dermatitis? A retrospective study

• Published in: The journal of allergy and clinical immunology in practice (Cambridge, MA)
• Main Authors: Tsui, Hung-Chang, Ronsmans, Steven, Hoet, Peter H M, Nemery, Benoit, Vanoirbeek, Jeroen A J
• Format: Journal Article
• Language: English
• Published: United States 01.09.2022
• Subjects: phenotype; contact dermatitis; asthma; rhinitis; occupational disease
• ISSN: 2213-2201
• DOI: 10.1016/j.jaip.2022.05.014

Occupational asthma (OA) may have different etiologies, but it is not clear whether the etiologic agents influence the clinical presentation, especially the co-occurrence of skin lesions. The aim of this study was to determine the impact of different asthmagens on the characteristics of OA, with a focus on the occurrence of prior or concomitant skin disorders. In a retrospective analysis of patients who visited the Occupational and Environmental Disease Clinic of a tertiary referral hospital from 2009 to 2019, we classified patients into definite, probable or possible OA according to prespecified diagnostic guidelines. In multivariate logistic regression with sensitivity analysis, we examined the relation of high- and low-molecular-weight (HMW and LMW) agents with the clinical presentation. Of 209 cases of OA, 66 were caused by HMW agents, and 143 by LMW agents. OA patients exposed to LMW agents had higher odds of having (had) allergic contact dermatitis (OR: 5.45 [1.80-23.70], p<0.01), compared with patients exposed to HMW agents. Conversely, HMW agents were associated with a higher odds of rhinitis symptoms (OR of LMW/HMW: 0.33 [0.17-0.63], p<0.001) and high total IgE (OR of LMW/HMW: 0.35 [0.17-0.70], p<0.01). Risk factors for having co-existing contact dermatitis included construction work, hairdressing, exposure to metals or epoxy resins. Among patients with occupational asthma, exposure to specific LMW agents was associated with a high frequency of contact dermatitis. Different types of asthmagens within HMW or LMW agents appear to determine the phenotype and co-morbidity of OA.