Rapid Responses to:

CLINICAL REVIEW: John Rees Prevalence BMJ 2005; 331: 443-445 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Occupational Asthma?

David S. Mallett   (19 August 2005)

Iatrogenic asthma

Wouter Havinga   (30 August 2005)

Occupational Asthma? 19 August 2005
David S. Mallett, Sp.R.Occ.Med Sheffield Send response to journal: Re: Occupational Asthma?	Many thanks to Dr. Rees for his structured overview of the subject of asthma. I am a little hesitant about whether or not to raise this point at the present as this is only the first of several articles. In the section on predisposing factors there is no mention of work related asthma. This is an area of quite high interest at the present. Estimates vary widely but, Kogevinas et al (1999) found that 0.2% to 0.5% of all adults (equating to around 10% of adults with a diagnosis of asthma) will have a workplace exposure that is either responsible for or significantly contributes to the illness. Certain compounds are recognised as being powerful 'sensitisers' for example isocyanates. Many other airborne particles, both organic and inorganic, have been found to induce asthma. Is the subject of work related asthma to be addressed in a later section? It is important that our colleagues in General Practice and in General Respiratory Medicine recognise that in addition to treating the patient, there are non-medical interventions that can be tried. In fact Health and Safety law requires that these interventions must be considered in an attempt to address the underlying cause. In short, the workplace might need 'treating' as well as the worker. I look forward to reading the rest of the series. Yours truly, Dr. David S. Mallett Sp.R.Occ.Med. Competing interests: None declared
Iatrogenic asthma 30 August 2005
Wouter Havinga, Sessional GP GL6 6JL Send response to journal: Re: Iatrogenic asthma	Early environmental factors are recognised as being linked to asthma. Steady additions to these early environmental factors are vaccinations and paracetamol (acetaminophen). Immunisations and anti-inflammatory drugs should be mentioned in the list of possible factors to explain the increased prevalence of asthma. Competing interests: None declared