Abstract

BACKGROUND:
Few data are reported on the effects of a reduction of exposure to specific sensitizers in occupational asthma (OA).
The objective of this study was to evaluate the clinical outcome of subjects with OA, comparing the effect of a reduction with that of the persistence or cessation of occupational exposure to the specific sensitizer.

SUBJECTS AND METHODS:
Forty-one subjects with OA due to different sensitizers were diagnosed via a specific inhalation challenge.
After a follow-up interval of 3.5 years, subjects were reexamined by clinical assessment, bronchial hyperresponsiveness (BH) and induced sputum.

RESULTS:
At follow-up, subjects who had reduced occupational exposure (n=2) showed a significant improvement in BH and a nonsignificant improvement in sputum eosinophilia (from 5.3 to 1.1%, n.s.), while subjects still exposed (n=10) showed a significant decrease in FEV(1). Subjects who ceased work (n=9) showed a trend of improvement in BH and sputum eosinophilia.Logistic analysis showed that the major determinant of improvement in BH at follow-up was the severity of BH at diagnosis, with a minimal contribution from the duration of exposure and treatment with inhaled corticosteroids during follow-up; reduction of work exposure did not enter into any model.

CONCLUSION:
The reduction of occupational exposure could not be considered to be as effective as work cessation, which remained the best treatment for OA.
However, it was not associated with a deterioration of FEV(1) as observed in subjects with persistent exposure.

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