Long-term clinical follow-up of irritant-induced occupational asthma.

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  • Additional Information
    • Source:
      Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 9422759 Publication Model: Electronic Cited Medium: Internet ISSN: 1470-7926 (Electronic) Linking ISSN: 13510711 NLM ISO Abbreviation: Occup Environ Med Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BMJ Pub. Group, c1994-
    • Subject Terms:
      Asthma, Occupational*/chemically induced ; Irritants*/adverse effects ; Occupational Exposure*/adverse effects; Humans ; Male ; Female ; Adult ; Middle Aged ; Follow-Up Studies ; Finland/epidemiology ; Surveys and Questionnaires ; Respiratory Function Tests ; Exercise Test ; Spirometry ; Bronchial Provocation Tests ; Occupational Diseases/chemically induced
    • Abstract:
      Background: Occupational exposure to irritants is associated with poor asthma control, but the long-term clinical characteristics of irritant-induced occupational asthma (IIA) are poorly known.
      Objective: To evaluate whether any distinguishable features contribute to IIA patients' poor outcomes and whether clinical characteristics change over time.
      Methods: We re-evaluated 28 IIA patients with a median of 6.8 years (IQR 4.6-11.1) after their diagnosis at the Finnish Institute of Occupational Health in 2004-2018. We measured their lung function, non-specific bronchial hyper-responsiveness, inflammation profile and exercise capacity using an ergometric bicycle test. The participants also underwent an Asthma Control Test (ACT) and responded to questionnaires assessing their laryngeal hypersensitivity (LHQ) and dysfunctional breathing (Nijmegen Questionnaires, NQ).
      Results: At follow-up, 22 (79%) participants used inhaled corticosteroids, 4 (14%) had asthma exacerbation within 1 year, 11 (39%) had ACT<20 (ie, poor asthma symptom control), 7 (26%) had abnormal spirometry and 8 (36%) had a positive methacholine challenge test result. 17 (61%) participants showed at least one elevated eosinophilic inflammation marker. Six (23%) had an abnormal LHQ score and 7 (26%) had an abnormal NQ score. 15 (58%) participants showed reduced physical capacity that was related to extensive asthma medication, poor asthma symptom control and acute IIA phenotype. A higher ACT score was the only significant change between diagnosis and follow-up (p=0.014).
      Conclusion: Most of the IIA patients had normal lung function at follow-up, which had only changed a little over time. Reduced physical capacity was a common finding and appears to be related to poor asthma symptom control.
      Competing Interests: Competing interests: None declared.
      (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.)
    • Contributed Indexing:
      Keywords: Allergy and Immunology; Asthma; Occupational Health
    • Accession Number:
      0 (Irritants)
    • Publication Date:
      Date Created: 20241113 Date Completed: 20241223 Latest Revision: 20241223
    • Publication Date:
      20241224
    • Accession Number:
      10.1136/oemed-2024-109540
    • Accession Number:
      39537354