An official ATS proceedings: asthma in the workplace: the Third Jack Pepys Workshop on Asthma in the Workplace: answered and unanswered questions

The Third Jack Pepys Workshop on Asthma in the Workplace held in Montreal, Canada in May 2007 focused on emerging data, including progress over the previous three years touching on questions identified at a previous Workshop (2004). The format, based on that used in previous workshops, consisted primarily of short, thematic, structured slide presentations followed by extensive, open-ended discussion periods. The key summary content of the workshops discussions has been distilled for this account. (Expanded details of the prepared presentations in PowerPoint format can be found at: www.asthma-workplace.com.) The topics reflect an expanded scope of interest including consideration of: (1) work-related asthma (WRA), subsuming both occupational asthma (OA) and work-exacerbated asthma (WEA); although the latter condition is commoner than OA, discussion mainly focused on OA because the corpus of scientific literature is larger; (2) other related occupational airway pathologic processes, beyond WRA, including rhinitis and eosinophilic bronchitis, with focus on various methods that improve objective confirmation of these conditions; (3) the psycho-socioeconomic impact of WRA with presentation of questionnaires that assess disability due to OA; (4) development of a world-wide perspective on work-related airway disease, including the situation in countries with emerging economies where the frequency of WRA is likely similar to or even greater than that in developed countries. The overarching conclusion was that WRA and related airway conditions are underrecognized and underdiagnosed both in developed and developing countries, with a great many aspects related to personal and environmental risk, exposure, mechanisms, and assessment of impairment/disability remaining to explore to better inform primary, secondary, and tertiary disease prevention.