In about 9–15% of asthma cases, the symptoms are work related. In addition, certain occupational conditions are involved – to widely varying degrees – in the development of COPD. The six main conditions that can result from acute inhalation intoxication are: acute toxic bronchitis/tracheitis, bronchoconstriction, obliterative bronchiolitis, alveolar damage, pulmonary edema, and asphyxia. Chronic bronchitis with an occupational component should always be seen as a warning. Occupational asthma can be due to immunologic or nonimmunologic triggers. The diagnosis is based mainly on the medical history and on a long-term record of changes in lung function, including changes in BHR. The prognosis is often poor. Occupational COPD is most common in miners, but chronic obstructive bronchitis can also occur after many years of occupational exposure to high concentrations of chemical irritants. Even the reasonable suspicion of an occupational disease is notifiable within the jurisdiction of the German legal system. Specific requirements relating to expert assessments are in place for the individual occupational illnesses, and these are briefly reviewed.
