The new guidelines for management of work-related asthma.

W ork-related asthma, which includes occupational asthma as well as work-aggravated asthma, has become one of the most prevalent occupational lung diseases. In spite of increasing knowledge of the causes and underlying pathophysiological mechanisms, this preventable disorder continues to account for at least 15% of all asthma cases in the adult population and is responsible for a significant socioeconomic burden [1, 2]. Using national data sets for 1999 from the USA, LEIGH and co-workers [3, 4] estimated the annual direct and indirect costs of occupational asthma and occupational chronic obstructive pulmonary disease (COPD) to be US $1.5 and $2.2 billion, respectively, mostly borne by affected workers, their families and the taxpayer. In 2005, the financial burden for work-related asthma and COPD (the latter only refers to hard coal miners) of the German statutory accident insurance institutions amounted J103.1 and J23.6 million, respectively [5]. The total costs across Europe are not known in detail, but should be more than J1.2 billion per year.