Airway allergy and worklife. Consensus report.

European researchers, mostly members and officers of the European Respiratory Society, attended a workshop called "The High Prevalence of Airway Allergy -- Implications for Work Life", in Brussels on 5-7 March 2000. The objective of the meeting was to delineate key issues and discuss central themes related to the topic on a collective level, instead of providing individual contributions, and this report was written as a result. It has been scrutinized and approved by the participants of the workshop, who are listed at the end of the report. Since the report is meant for members of the medical profession and for decision makers in the European Union (EU), it has been written for a wide audience. For this purpose some information available in common textbooks is provided, although it was not discussed at the workshop, since it was common knowledge among the participants. Background Five to ten percent of the general population in Europe has asthma (1-5). This is a much higher figure than was the case a few decades ago. It is estimated that worldwide some 100-150 million persons have asthma. Part of the explanation for the increase in asthma is a population shift in the immune system. As a result, the risk of becoming allergic to common substances in the air, typically proteins from mites, pollen or furred animals, has clearly increased. This increase in the disposition to develop allergic disease affects a large part of the population (40-50%). The cause of this change is unknown, but it is has been attributed to factors in early childhood (2, 6, 7). Allergic disposition may result in asthma in childhood or in asthma with adult onset. Occupational exposure to both high- and low-molecular-weight agents may cause adult onset asthma, but in at least half of the cases with adult onset asthma it is not possible to identify a causal agent (8, 9). Asthma is more common in teenagers than in adults, and, according to some estimates, more than 10% of young persons have asthma (1). The highest prevalence of asthma in the adult population is found in some countries of western Europe, where up to 10% of the population has this diagnosis. Asthma (but not asthmatic symptoms like wheezing) and allergy appear to be less common in eastern European countries (2). The prevalence of recognized allergies is, however, rising also in these countries (10). A consequence of this change in the general population is that more people with asthma are now entering worklife. In addition, growing numbers of persons at work have an increased susceptibility to develop asthma from exposures to agents in the workplace.