Occupational Asthma Reference

Malo J, LArchevêque J, Castellanos L, Lavoie K, Ghezzo H, Maghni K, Long-Term Outcomes of Acute Irritant-induced Asthma, Am Rev Respir Med, 2009;179:923-928,
(Plain text: Malo J, LArcheveque J, Castellanos L, Lavoie K, Ghezzo H, Maghni K, Long-Term Outcomes of Acute Irritant-induced Asthma, Am Rev Respir Med)

Keywords: irritant induced asthma, rads, canada, prognosis, follow-up

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

Karim Maghni, Hôpital de Sacré Coeur, Montreal, Quebec, Canada Karim Maghni

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Abstract

Rationale: The long-term outcomes of acute irritant-induced asthma (IIA) are mostly unknown.

Objectives: To study the long-term outcomes of IIA.

Methods: We reassessed 35 subjects who experienced IIA at a mean interval of 13.6 ± 5.2 years.

Measurements and Main Results: The causal agent was chlorine in 20 cases (57%). At diagnosis, the mean ± SD FEV1 was 74.5 ± 19.5% predicted, and all subjects showed bronchial hyperresponsiveness. At reassessment, all subjects reported respiratory symptoms, and 24 (68%) were on inhaled steroids. There were no significant improvements in FEV1 and FEV1/FVC values. Twenty-three subjects had a methacholine test, and only six subjects had normal levels of responsiveness. Of the remaining 12 subjects, six had improvement in FEV1 after bronchodilator 10%. In samples of induced sputum obtained from 27 subjects, six had eosinophils 2%. Levels of inflammatory and remodeling mediators were higher than in control subjects but were no different from subjects with occupational asthma due to sensitization. Quality of life score was 4.4 ± 1.5 on a 0 (worst) to 7 (best) scale. Twelve subjects had an abnormal depression score.

Conclusions: This study provides the first evidence of significant long-term impact of acute IIA on various outcomes.

Plain text: Rationale: The long-term outcomes of acute irritant-induced asthma (IIA) are mostly unknown. Objectives: To study the long-term outcomes of IIA. Methods: We reassessed 35 subjects who experienced IIA at a mean interval of 13.6 +- 5.2 years. Measurements and Main Results: The causal agent was chlorine in 20 cases (57%). At diagnosis, the mean +- SD FEV1 was 74.5 +- 19.5% predicted, and all subjects showed bronchial hyperresponsiveness. At reassessment, all subjects reported respiratory symptoms, and 24 (68%) were on inhaled steroids. There were no significant improvements in FEV1 and FEV1/FVC values. Twenty-three subjects had a methacholine test, and only six subjects had normal levels of responsiveness. Of the remaining 12 subjects, six had improvement in FEV1 after bronchodilator 10%. In samples of induced sputum obtained from 27 subjects, six had eosinophils 2%. Levels of inflammatory and remodeling mediators were higher than in control subjects but were no different from subjects with occupational asthma due to sensitization. Quality of life score was 4.4 +- 1.5 on a 0 (worst) to 7 (best) scale. Twelve subjects had an abnormal depression score. Conclusions: This study provides the first evidence of significant long-term impact of acute IIA on various outcomes.

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