Occupational Asthma Reference

Yacoub M-R, Lavoie K, Lacoste G, Daigle S, L’Archevêque J, Ghezzo H, Lemière C,Malo J-L, Assessment of impairment/disability due to occupational asthma through a multidimensional approach, Eur Respir J, 2007;29:889-896,
(Plain text: Yacoub M-R, Lavoie K, Lacoste G, Daigle S, L'Archeveque J, Ghezzo H, Lemiere C,Malo J-L, Assessment of impairment/disability due to occupational asthma through a multidimensional approach, Eur Respir J)

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Known Authors

Jean-Luc Malo, Hôpital de Sacré Coeur, Montreal, Quebec, Canada Jean-Luc Malo

Kim Lavoie, Hôpital de Sacré Coeur, Montreal, Quebec, Canada Kim Lavoie

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Abstract

Subjects with occupational asthma (OA) are often left with permanent sequelae after removal from exposure, and assessing their impairment/disability should utilise various tools.

The aim of the present study was to examine whether: 1) assessment of inflammation in induced sputum is relevant to impairment; and 2) use of questionnaires on quality of life and psychological factors can be useful for the evaluation of disability. In total, 40 subjects were prospectively assessed for permanent impairment/disability due to OA 2 yrs after cessation of exposure. Impairment was assessed as follows: 1) need for asthma medication; 2) asthma severity; 3) airway calibre and responsiveness; and 4) degree of inflammation in induced sputum. Disability was assessed according to quality of life and psychological distress.

There was a significant improvement in airway responsiveness and inflammation from diagnosis to the present assessment. Sputum eosinophils 2% and neutrophils >60% were present in eight (20%) and 12 (30%) out of all subjects, respectively, one or the other feature being the only abnormalities in 15% of subjects. Quality of life was moderately affected and there was a prevalence of depression and anxiety close to 50%.

In the assessment of subjects with occupational asthma, information on airway inflammation and psychological impacts are relevant to the assessment of impairment/disability, although these findings need further investigation.


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Associated Questions

Registered users of this website have associated this reference with the following questions. This association is not a part of the BOHRF occupational asthma guidelines.

What is the prognosis of occupational asthma?
burgeps 5/40 (12.5%) were considered cured 2 years after a diagnosis of occupational asthma in Montreal. 8 (20%) had been successfully relocated away from exposure by their original employer and 13 (32.5%) were working for a different employer. 7 (17.5%) were retired prematurely, 7 were unemployed or doing part-time work and 5 (12.5%) were being retrained. FEV1 had not improved at follow-up, but non-specific reactivity and sputum eosinophilia had improved. 52.5% were abnormally anxious and 47.5% depressed using the PSI questionnaire at follow-up.
What is the impact of occupational asthma on employment?
burgeps A follow-up of 40 workers with occupational asthma 2 years after diagnosis showed 8 (20%) had been successfully relocated away from exposure by their original employer and 13 (32.5%) were working for a different employer. 7 (17.5%) were retired prematurely, 7 were unemployed or doing part-time work and 5 (12.5%) were being retrained.
What are the sensitivity and the specificity of a normal measurement of non-specific reactivity while at work in the diagnosis of occupational asthma?
burgeps 1/40 had normal methacholine reactivity (>16mg/ml at diagnosis)

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