Sex- and Gender-Based Differences in Asthmatic Responses to Chemical Sensitizers, Particularly in Occupational Settings: A Scoping Review

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Asthma is a chronic respiratory disease resulting from a complex interplay of genetic, environmental, and occupational factors. Key environmental risks include exposure to tobacco smoke and respiratory sensitizing agents, many of which are prevalent in workplace settings. In adults, asthma is associated with reduced employment, job instability, and work-related disability, resulting in significant social and economic consequences. This scoping review investigates the role of exposure to respiratory sensitizers in the onset and progression of asthma, considering data from the general population to occupational settings, with a focus on sex and gender as key modifiers of risk, disease severity, and occupational outcomes. Biological studies were also considered to clarify the mechanisms underlying observed sex/gender differences. Epidemiological data indicate that women are disproportionately affected by asthma, experiencing more severe symptoms, higher comorbidity rates, and increased exposure in certain professions such as healthcare, cleaning, and textile work. These disparities are attributed to both sex-related factors (e.g., hormonal influences) and gender-related factors (e.g., occupational roles, smoking habits). Although traditional job roles are changing, women continue to face greater occupational asthma risks. As roles evolve, physiological sex-based differences may become increasingly relevant in shaping asthma susceptibility. This review emphasizes the need for sex- and gender-sensitive strategies in asthma prevention, surveillance, and management, especially in occupational health contexts.

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