Prevention of complications : the optimal treatment for occupational
allergies
is removal from exposure, which in practice may be difficult to achieve.
The removal or reduction of the exposure may involve avoidance of certain
tasks and exposurs, relocation to other areas or processes within the workplace,
use of protective equipment, etc. Personal protective equipment may benefit
some workers with asthma and adequate ongoing exposure monitoring is important.
Replacement of powdered latex gloves with poderless or non-latex gloves
for all workers may reduce ambient concentrations of latex allergens, and
this may be sufficient to prevent symptoms in workers with already established
occupational asthma. A further possibility of the tertiary prevention may
involve a change of occupation and retraining. If possible, patients affected
by occupational allergies must be relocated to a new job, which neither
presents exposure to the causative sensitizers, nor significant exposurs
to other irritant agents. The last resort is removal of te patient entirely
from the workplace. Unfortunately, removal from the exposure is not always
associated with a complete recovery from the disease in occupational diseases,
both in asthma and in the skin. Eczematous lesions of allergic contact
dermatitis may reach chronic stages with a long interval between the sensitization
and the removal. Negative prognostic factors for occupational asthma
are :
type of causal allergen, in particular LMW substances (such as di-isocyanates,
colophony umes and platinum salts)
long duration of symptoms before diagnosis
severity of symptoms and airway obstruction at the time of cesation of
exposure
dual response after specific challenge test
persistence of markers of inflammation in BAL and in induced sputum
prior history of wheezing or of smoking
Employees suffering from an occupational illness are often retired or dismissed
on "medical" grounds. 2 specific questions need to be answered with regard
to such a decision on grounds of occupational asthma :
is the employee not well enough in terms of physical capacity to perform
work, and so liokely to remain unwell that no other job is possible for
that particular employee ?
are all the possible jobs so unsafe because of exposure to the sensitizer
or to nonspecific irritants, that this employee could not undertake any
such jobs without significant risks to his health and safety ?
Of course all efforts for therapeutic management of the suffering worker,
are to be pursued in any case
Rehabilitation medicine : the branch of physiatrics concerned
with restoration of form and function after injury or illness by physiotherapy
kinesitherapy : the therapeutic and
corrective application of passive and active movements and of exercise
forced passive mobilization to overwhelm articular resistances due
to cicatricial adherences. Muscles are relaxed and the painless position
is maintained for cycles of 10-15 minutes a day
active kinesitherapy
segmentary exercises (isometric > isotonic contractions) to recover
muscle tone
global exercises (involving also not injured body areas)
hydrokinesitherapy
work hardening : program of conditioning exercises (8 hrs/day x
2-4 weeks)
gymnastics : systematic muscular exercise.
ocular gymnastics : systematic exercise of the eye muscles in order
to secure proper movement, accommodation, or fixation.
Swedish gymnastics : a system of exercise following a rigid pattern
of carefully chosen free, active, deliberate movement, utilizing little
equipment and stressing correct bodily posture.
is removal from exposure, which in practice may be difficult to achieve.
The removal or reduction of the exposure may involve avoidance of certain
tasks and exposurs, relocation to other areas or processes within the workplace,
use of protective equipment, etc. Personal protective equipment may benefit
some workers with asthma and adequate ongoing exposure monitoring is important.
Replacement of powdered latex gloves with poderless or non-latex gloves
for all workers may reduce ambient concentrations of latex allergens, and
this may be sufficient to prevent symptoms in workers with already established
occupational asthma. A further possibility of the tertiary prevention may
involve a change of occupation and retraining. If possible, patients affected
by occupational allergies must be relocated to a new job, which neither
presents exposure to the causative sensitizers, nor significant exposurs
to other irritant agents. The last resort is removal of te patient entirely
from the workplace. Unfortunately, removal from the exposure is not always
associated with a complete recovery from the disease in occupational diseases,
both in asthma and in the skin. Eczematous lesions of allergic contact
dermatitis may reach chronic stages with a long interval between the sensitization
and the removal. Negative prognostic factors for occupational asthma
