OCCUPATIONAL RESPIRATORY DISEASE SURVEILLANCE

State-Based Surveillance

Work-Related Asthma (WRA)

Massachusetts, Michigan, and New Jersey have maintained WRA surveillance programs since 1988. New Jersey has maintained a WRA surveillance program from 1987–2015. California has maintained a WRA surveillance program since 1993, and Washington began surveillance for WRA in 2002. New York conducts surveillance for all occupational lung diseases, including WRA, through its long-standing Occupational Lung Disease Registry. Health care professional reports represent the primary ascertainment source in Massachusetts, Michigan, New Jersey, and California. California identifies cases by reviewing data from Doctor's First Reports (DFR) of Occupational Injury or Illness, a longstanding statewide health care professional reporting system linked to reimbursement for medical services. The primary ascertainment source in New York is hospital discharge data. Washington identifies cases through their state Workers' Compensation system; employers in Washington are required to obtain State Fund insurance unless they are able to self-insure. Several states use multiple data sources to identify cases including hospital discharge data, emergency room data, workers' compensation data, as well as Poison Control data in Michigan. State surveillance staff collect demographic, work-history, and medical information for case confirmation, classification, and description through a combination of data sources, review of medical records, and when possible, a follow-up interview with reported cases.

Surveillance Guidelines for State Health Departments

Recommended guidelines for identifying and reporting actual or suspected cases of work-related asthma.

• State Reporting Guidelines for WRA
• Surveillance Case Definition for WRA
• WRA Surveillance Categories
• Decision Logic and Case Classification for WRA
• Surveillance Case Classification Criteria for WRA

Asthmagens

Association of Occupational and Environmental Clinics (AOEC) Exposure Codes
An exposure coding scheme which includes agents classified as "known asthma inducers" and is maintained by the Association of Occupational and Environmental Clinics (AOEC). To facilitate consistency in agent coding across states, putative causes of WRA for each case are coded using this scheme.

Haz-Map
An occupational toxicology database (of chemicals, jobs, and diseases) designed to link jobs to hazardous job tasks which are linked to occupational diseases and their symptoms.

NIOSHTIC-2 Searches

NIOSHTIC-2 is a searchable bibliographic database of occupational safety and health publications, documents, grant reports and journal articles supported in whole or in part by NIOSH.
Search Results for Asthma (Search Terms: work-related asthma OR occupational asthma OR exacerbated asthma OR aggravated asthma OR irritant-induced asthma.)

Selected Resources and References

Air Pollution and Respiratory Health Program of the National Center for Environmental Health (NCEH)
NCEH leads CDC's fight against environmental-related respiratory illnesses, including asthma, and studies indoor and outdoor air pollution.

British Occupational Health Research Foundation (BOHRF)
Includes evidence-based review and guidelines for the identification, management, and prevention of occupational asthma.

Clinical Evaluation, Management, and Prevention of Work-Related Asthma
Am J Ind Med 2000 Jan;37(1):121-41.
A practical stepwise organization of the diagnostic evaluation of work-related asthma, used by primary care physicians and physicians specializing in occupational diseases and asthma (2000).

Council of State and Territorial Epidemiologists (CSTE), Occupational Health Indicators
Occupational health indicator data from states and, where available, the United States: One indicator relates to work-related asthma, Indicator #21: Asthma Among Adults Caused or Made Worse by Work.

Diagnosing Work-Related Asthma
An on-line Continuing Medical Education (CME) developed by the Washington State Department of Labor Industries, Safety Health Assessment Research for Prevention (SHARP) Program (2006).

Work-Related Asthma
Am Fam Physician 2001 Dec;64(11):1839-1849.
Diagnosis, treatment, prevention, and reduction to exposure are all important steps taken by the physician of victims of work-aggravated asthma, occupational asthma, reactive airways dysfunction syndrome, and allergic occupational asthma.

Work-Related Lung Disease Surveillance System (eWoRLD), Work-Related Asthma: State-Based Surveillance
Work-Related Lung Disease Surveillance System (eWoRLD) provides state-based surveillance data for work-related asthma from participating states.