A Proposal from the Montpellier World Health Organization Collaborating Centre for Better Management and Prevention of Anaphylaxis.

Since the first description of anaphylaxis in 1902, its clinical importance as an emergency condition has been recognized worldwide. Anaphylaxis is a severe, potentially life-threatening systemic hypersensitivity reaction characterized by rapid onset and the potential to endanger life through respiratory or circulatory compromise. It is usually, although not always, associated with skin and mucosal changes. Although the academic/scientific communities have advocated to promote greater awareness and protocols for the management of anaphylaxis based on best evidence, there are few efforts documenting feedback as to the success of these efforts. In this article, we review the key unmet needs related to the diagnosis and management of anaphylaxis, and propose a public health initiative for prevention measures and a timetable action plan that intends to strengthen the collaboration among health professionals and especially primary care physicians dealing with anaphylaxis, which can encourage enhanced quality of care of patients with anaphylaxis. More than calling for a harmonized action for the best management of anaphylaxis to prevent undue morbidity and mortality, the Montpellier World Health Organization Collaborating Centre here proposes an action plan as a baseline for a global initiative against anaphylaxis. We strongly believe that these collaborative efforts are a strong public health and societal priority that is consistent with the overarching goals of providing optimal care of allergic patients and best practices of allergology.

[Occupational asthma]. / Asma profesional.

Occupational bronchial asthma is a diagnostic, therapeutic and public health problem. The central clue for a proper diagnosis is to consider the problem when evaluating every patient with adult onset asthma. An objective confirmation is mandatory because clinical history often gives rise to many false positive cases. Avoidance of contact with the causative agent usually requires the change of work activity which results in an income decrease or unemployment. Despite many efforts in industrial hygiene, recent data shows asthma as the most prevalent cause in the Western world of occupational respiratory disease during working life. The challenge, from an occupational public health standpoint is to create the appropriate industrial hygiene conditions to reduce the burden of worker's exposure to allergens.