New causes of occupational asthma.

PURPOSE OF REVIEW This review focuses on new causative agents of occupational asthma published in 2009 and 2010. The recent developments in the diagnostic tools employed in occupational asthma caused by new agents are summarized. RECENT FINDINGS Work exposures are a significant contributor to the burden of asthma and, therefore, there is great scientific interest in work-related asthma. Although the majority of cases probably represent work-aggravated asthma, in a relevant proportion of cases asthma is actually caused by one or more agents present in the workplace. The list of causative agents of immunologically mediated occupational asthma is continuously growing, and new agents and professions are described each year. New insights gained in occupational asthma include routine evaluation of airway inflammation and identification of allergenic triggers using molecular diagnosis. SUMMARY A variety of novel high and low-molecular-weight agents have been shown to induce occupational asthma. Apart from the identification of the allergenic sources implicated, molecular diagnosis and detailed characterization of the culprit allergens contributes to increase our knowledge into the pathogenic mechanisms of this disorder. Assessment of airway inflammation helps to confirm the diagnosis and to better understand the physiopathology of the different types of occupational asthma.