Bronchial asthma and work in high-altitude mines

In occupational health, the management of patients with preliminary and periodic medical examinations for work in harmful conditions, for example, in high-altitude conditions, can be a difficult task. Bronchial asthma is one of the unequivocal contraindications to work in the highlands, however, in light of recent successes in achieving asthma control and the introduction of new types of therapy, this issue may require additional discussion. The article presents arguments both in favor of admitting patients with bronchial asthma to the highlands and against such a decision. The first group includes the elimination of allergens, long-term successes in the treatment of bronchial asthma in the highlands, as well as the fact that the decision not to allow it was popular in the era before the introduction of effective basic therapy for bronchial asthma with inhaled corticosteroids. The group of arguments "against" includes cold air, possible compensation only at relatively low altitudes, as well as remoteness, the inability to fully control compliance with patient requirements and the presence of typical industrial hazards in the form of allergens and irritants in production. It is particularly possible to emphasize the weakness of the evidence base, the extremely scarce number of published studies and the need for careful planning and conducting high-quality prospective observations of high-altitude mine workers, which can serve as a basis for the formation of an evidence base for adjusting admission conditions in the future. Ethics. The study did not require permission. © 2023, Izmerov Research Institute of Occupational Medicine. All rights reserved.