Medline ® Abstracts for References 21,25
of 'Reactive airways dysfunction syndrome and irritant-induced asthma'
Survey of construction workers repeatedly exposed to chlorine over a three to six month period in a pulpmill: II. Follow up of affected workers by questionnaire, spirometry, and assessment of bronchial responsiveness 18 to 24 months after exposure ended.
Bhérer L, Cushman R, Courteau JP, Quévillon M, CôtéG, Bourbeau J, L'Archevêque J, Cartier A, Malo JL
Occup Environ Med. 1994;51(4):225.
OBJECTIVE: The aim was to determine the prevalence of persistent respiratory symptoms and bronchial hyper-responsiveness due to reactive airways dysfunction syndrome in a population of construction workers at moderate to high risk of developing the syndrome, at an interval of 18 to 24 months after multiple exposures to chlorine gas during renovations to a pulp and paper mill.
DESIGN AND PARTICIPANTS: 71 of 289 exposed workers (25%) were identified on the basis of an exposure and the onset of respiratory symptoms shortly after this event (moderate to high risk). A standardised respiratory questionnaire was first presented, followed by spirometry and a methacholine inhalation test on those whose questionnaire suggested the persistence of respiratory symptoms.
RESULTS: 64 of 71 (90%) subjects completed the respiratory questionnaire at the time of the follow up. The questionnaire suggested a persistence of respiratory symptomsin 58 of the 64 workers (91%). Of the 58 subjects, 51 underwent spirometry and assessment of bronchial responsiveness. All of them used bronchodilators as required (not regularly) and four required inhaled anti-inflammatory preparations. Sixteen had bronchial obstruction (forced expiratory volume in one second) (FEV1<80% predicted) and 29 showed significant bronchial hyper-responsiveness.
CONCLUSION: Of the subjects (n = 71) who were at moderate to high risk of developing reactive airways dysfunction syndrome after being exposed to chlorine and were seen 18 to 24 months after exposure ended, 58 (82%) still had respiratory symptoms, 16 (23%) had evidence of bronchial obstruction, and 29 (41%) had bronchial hyper-responsiveness.
Outaouais Community Health Department (DSC), Hull, Quebec, Canada.
Work-related reactive airways dysfunction syndrome cases from surveillance in selected US states.
Henneberger PK, Derk SJ, Davis L, Tumpowsky C, Reilly MJ, Rosenman KD, Schill DP, Valiante D, Flattery J, Harrison R, Reinisch F, Filios MS, Tift B
J Occup Environ Med. 2003;45(4):360.
The objective was to elaborate the descriptive epidemiology of work-related cases of reactive airways dysfunction syndrome (RADS). Cases of work-related asthma (WRA) were identified in four states in the United States during 1993-1995 as part of the Sentinel Event Notification Systems for Occupational Risks (SENSOR). Information gathered by follow-back interview was used to describe 123 work-related RADS cases and to compare them to 301 other WRA cases whose onset of disease was associated with a known asthma inducer. RADS represented 14% of all new-onset WRA cases identified by the state SENSOR surveillance systems. RADS cases had significant adverse medical and occupational outcomes identified by follow-back interview. In particular, 89% still had breathing problems, 78% had ever sought emergency care and 39% had ever been hospitalized for work-related breathing problems, 54% had applied for worker compensation benefits, and 41% had left the company where they experienced onset of asthma. These values equaled or exceeded the comparable figures for those WRA cases whose onset was attributed to a known inducer. Work-related RADS represents a minority of all WRA cases, but the adverse impact of this condition appears toequal that of other WRA cases.
National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Road M/S H-2800, Morgantown, WV 26505, USA. firstname.lastname@example.org