Metal-Induced Work-Related Asthma: Analysis of Clinical Features and Occupational Outcomes

Abstract

<bold>Introduction:</bold> Allergic asthma represents the most common occupational respiratory disease. While often underestimated, metal-induced asthma affects an increasing number of workers exposed to specific metals in their occupational setting. <bold>Objective:</bold> To establish the socio-demographic, occupational, clinical, and paraclinical profile of patients with occupational allergic asthma due to metal exposure. <bold>Methods:</bold> We conducted a retrospective descriptive epidemiological study including all cases of occupational allergic asthma due to metals reported in the private sector in Tunisia from 2002 to 2023 and recognized by the competent medical committees of the National Health Insurance Fund (CNAM). <bold>Results:</bold> We report 12 cases of occupational asthma. Mean age was 44.18 ± 8 years. The two main activity sectors involved were metal construction and leather industry. The metals responsible for occupational allergic asthma were Nickel in 1 case, Chromium in 6 cases, and sintered metal carbide dust in 5 cases. The most frequently encountered symptoms were dyspnea and chest tightness. These symptoms were work-related in 80% of cases. Pulmonary function tests showed reversible obstructive ventilatory disorder in most cases. Professional reclassification was implemented in 85% of cases. <bold>Conclusion:</bold> Better awareness, early detection, and appropriate preventive measures are crucial to reduce the incidence of occupational asthma and improve the quality of life of exposed workers. Close collaboration between occupational physicians, allergists, and employers is necessary to ensure a safe work environment and limit risks associated with these exposures.