Module 4: Occupational Asthma - Lecture (Continued)

8. PROGNOSIS:

• Factors determining prognosis among workers returning to job while on medication is dependent on:

  • whether exposure can be substantially reduced;
  • type of agent;
  • severity of the clinical response;
  • availability of work alternatives.


• Mean time to the plateau for improvement of pulmonary function after removal from exposure is 2 years.

• Poor prognostic features identified in workers after removal from exposure include:

  • Longer period of exposure before the development of symptoms;
  • Longer duration of symptoms before diagnosis;
  • Significant non-specific bronchial hyperreactivity at presentation
  • Low baseline FEV₁ (initial lung function);
  • Late initiation of treatment (steroids) after diagnosis.


• Even with no further exposure, the prognosis is uncertain.
• COIDA makes provision for paying medical expenses for only 24 months, while allowing for further discretionary payment to "reduce disablement"
• Alternatives to current compensation: emphasis towards assisting relocation and retraining rather than providing inadequate compensation for disability.