Abstract

Background
In asthmatics, a rapid decline in pulmonary function is observed, likely as a consequence of airways remodeling. Persistence of allergen exposure in patients with occupational asthma (OA) maintains chronic bronchial
inflammation, resulting in a more severe lung function decline. Few studies were performed on the efects of allergen exposure cessation.

Objective
This study aims at evaluating the infuence of allergen exposure cessation on respiratory decline in allergic asthmatic workers.

Methods
Two groups of workers with allergic OA were selected. The first group (30 workers) changed job after the diagnosis and was no more exposed to sensitizing allergens, and the second group (28 subjects) did not and, as a
consequence of preventive measures in the work place, was exposed to a lower level of allergens. All were treated with conventional therapy, according to GINA protocols. FEV1 changes during a 12-year period were evaluated.

Results
Despite pharmacological therapy, the pulmonary function decay slope was steeper in workers continuously exposed to the sensitizing agent (even at reduced level) than in those with a complete cessation of exposure: Final
FEV1 loss was 512.5 +/- 180 ml versus 332.5 +/- 108 ml, respectively. The diference became significant after 4 years from the cessation of the exposure.

Conclusions
The study shows that the cessation of the exposure to allergen in the work place appears the most eVective measure in limiting pulmonary function decline in asthmatic workers and underlines the importance of allergic
risk assessment and control in the management of occupational asthma.

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