Occupational Asthma Reference

Dufour M-H, Lemière C, Prince P, Boulet L-P, Comparative airway response to high- versus low-molecular weight agents in occupational asthma, Eur J Respir Dis, 2009;33:734-739,
(Plain text: Dufour M-H, Lemiere C, Prince P, Boulet L-P, Comparative airway response to high- versus low-molecular weight agents in occupational asthma, Eur J Respir Dis)

Keywords: Canada,

Known Authors

Catherine Lemière, Hôpital de Sacré Coeur, Montreal, Quebec, Canada Catherine Lemière

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Abstract

Airway responses to occupational agents in sensitised workers may vary clinically and physiologically. The patterns of change in airway responsiveness, type of response and fall in expiratory flows following laboratory exposure to high- or low-molecular weight agents (HMW and LMW agents, respectively) were compared in sensitised workers.

Data on workers who underwent specific inhalation challenges with occupational sensitisers (117 exposed to HMW agents and 130 to LMW agents) were collected from their medical charts.

Maximum falls in forced expiratory volume in one second (FEV1) were of similar magnitude for both types of agents. Compared with HMW agents, LMW agents induced more frequently late or dual responses and higher increases in airway responsiveness. After exposure to HMW agents, there was a mean±SD reduction in doubling concentrations of methacholine of 0.5±1.7 for early responses, compared with 2.8±1.2 and 1.4±2.0 for late and dual responses, respectively. Isolated early responses were more frequently found in females, smokers, workers with a higher % predicted FEV1 and higher provocation concentration causing a 20% fall in FEV1, and in those with longer asthma duration.

Workers’ characteristics, as well as the type of agent they are sensitised to, may help to predict the type of response after specific inhalation challenge

Plain text: Airway responses to occupational agents in sensitised workers may vary clinically and physiologically. The patterns of change in airway responsiveness, type of response and fall in expiratory flows following laboratory exposure to high- or low-molecular weight agents (HMW and LMW agents, respectively) were compared in sensitised workers. Data on workers who underwent specific inhalation challenges with occupational sensitisers (117 exposed to HMW agents and 130 to LMW agents) were collected from their medical charts. Maximum falls in forced expiratory volume in one second (FEV1) were of similar magnitude for both types of agents. Compared with HMW agents, LMW agents induced more frequently late or dual responses and higher increases in airway responsiveness. After exposure to HMW agents, there was a mean+-SD reduction in doubling concentrations of methacholine of 0.5+-1.7 for early responses, compared with 2.8+-1.2 and 1.4+-2.0 for late and dual responses, respectively. Isolated early responses were more frequently found in females, smokers, workers with a higher % predicted FEV1 and higher provocation concentration causing a 20% fall in FEV1, and in those with longer asthma duration. Workers' characteristics, as well as the type of agent they are sensitised to, may help to predict the type of response after specific inhalation challenge

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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 are the sensitivity and the specificity of a normal measurement of non-specific reactivity while at work in the diagnosis of occupational asthma?
burgeps The individual sults of NSBR e not given, but the mean methacholine Pc20 was 3.5 mg/ml (0.02-112) ffor low w allegens pre challenge and 2.7 mg/ml (0.04-128) or high mw agents The cchages post challege wwere sall (LMW 1.8 +/- 2.3, HMW 0.8 +/- 1.8). The changes following immediate reactions (were lower than those following late reations as expected) but only for high MW agents

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