{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T05:41:45Z","timestamp":1792388505057,"version":"4.4.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Work-related asthma in welders is often thought to be irritant rather than allergic, limiting the availability of surveillance, assisted retraining and compensation. However, excess inflammatory gene activation is a feature of asthma in stainless-steel welders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate a cohort of workers exposed to stainless-steel welding fume who have work-related symptoms to assess if their diagnosis best fits irritant or allergic phenotypes or endotypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All workers seen between 2000 and 2021 with confirmed work-related asthma exposed to stainless-steel welding fume were included. The types of exposure responses were identified from Oasys programme plots of 2-hourly peak expiratory flow (PEF) measurements at work and home over 4\u2009weeks. While exposed, non-specific bronchial reactivity (NSBR), atopy, eosinophilia and fractional exhaled nitric oxide (FeNO) were measured. The irritant endotype was defined as (i) absence of relevant immunoglobulin E sensitization; (ii) association with NSBR; (iii) immediate onset of symptoms following exposure; and (iv) either pre-existing asthma or a latency period for symptom onset of &amp;lt;6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-five workers exposed to stainless-steel welding fume showed PEF changes, confirming work-related asthma. A possible irritant endotype was present in four. One had pre-existing asthma, two had latencies of &amp;lt;6\u2009months and three had NSBR. Peripheral eosinophilia and raised FeNO were uncommon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The phenotype or endotype was incompatible with purely irritant mechanisms in 21 participants and had predominately T helper 2 low inflammatory characteristics. Stainless-steel welders with work-related asthma should be managed as occupational asthma with hypersensitivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/occmed\/kqag068","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:57:49Z","timestamp":1782860269000},"page":"409-416","source":"Crossref","is-referenced-by-count":0,"title":["Work-related asthma in stainless steel welders, irritant or allergy?"],"prefix":"10.1093","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5990-8273","authenticated-orcid":false,"given":"Vicky C","family":"Moore","sequence":"first","affiliation":[{"name":"Occupational Lung Disease Service, Birmingham Heartlands Hospital , Birmingham B9 5SS,","place":["UK"]},{"name":"University Hospitals Coventry and Warwickshire Respiratory and Sleep Sciences, , Coventry, CV2 2DX,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair 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