Table 5. Recommendations
RecommendationStrength of recommendationQuality of evidence
Patients, physicians, and employers should be informed that persistence of exposure to the causal agent is likely to result in a deterioration of asthma symptoms and airway obstructionStrongModerate
Patients and their attending physicians should be aware that complete avoidance of exposure is associated with the highest probability of improvement, but may not lead to a complete recovery from asthmaStrongModerate
Reducing exposure to the causal agent can be considered an alternative to complete avoidance in order to minimise the adverse socioeconomic consequences, but available evidence is insufficient to recommend this option as a first-choice therapeutic strategy. This approach requires careful medical monitoring in order to ensure an early identification of asthma worseningWeakLow
The use of respiratory protective devices should not be regarded as a safe approach, especially in the long term and in patients with severe asthmaStrongLow
Anti-asthma medications should not be regarded as a reasonable alternative to environmental interventionsStrongVery low
The pharmacological treatment of work-related asthma should follow the general recommendations for asthmaStrongModerate
  • The strength of the recommendations and the quality of underlying evidence were graded using the Grading of Recommendations Assessment, Development and Evaluation approach [67].