CHEST Guidelines-Occupational-and-Environmental-Contributions-to-Ch

Occupational-and-Environmental-Contributions-to-Ch

Pdf Summary

The 2016 CHEST Expert Panel Report examines the occupational and environmental factors contributing to chronic cough in adults. This document offers a comprehensive update to previous guidelines, focusing on new aspects not covered before. Chronic cough can result from environmental irritants either as an isolated symptom or as an indication of more serious diseases. <br /><br />The panel performed a literature review using MEDLINE and TOXLINE, supplemented by expert input to uncover these often-overlooked causes. The results highlighted various mechanisms causing cough, allergic reactions, the impacts of cigarette and marijuana smoke, non-allergic environmental triggers, and occupational diseases.<br /><br />Key suggestions from the panel include:<br />1. During evaluations of chronic cough, a standard practice should be to assess for occupational and environmental causes, noting the duration and severity of exposure, smoking history, and atopic history.<br />2. When an occupational or environmental link is suspected, it should be objectively confirmed through testing to ensure effective patient outcomes.<br />3. Patients should undergo relevant tests, such as pulmonary function tests or immunology evaluations, to clarify exposure-related connections to cough.<br />4. If there’s a high suspicion of environmental or occupational causes, management should align with evidence-based guidelines, considering referrals to specialists when necessary.<br /><br />Despite advancements in understanding these environmental and occupational triggers, a gap remains between recommended assessments and actual clinical practice. Future research should focus on better documentation and understanding of these influences on chronic cough. This includes developing diagnostic tests and studying larger populations to quantify the occupational burden of chronic cough. The recognition of occupational and environmental causes is critical for effective symptom management, prevention measures, and ensuring adequate worker protections.

Keywords

chronic cough

occupational factors

environmental factors

CHEST Expert Panel

cough mechanisms

allergic reactions

cigarette smoke

occupational diseases

diagnostic tests

symptom management