Medline ® Abstracts for References 21,25

of 'Reactive airways dysfunction syndrome and irritant-induced asthma'

21
TI
Longitudinal assessment of airway caliber and responsiveness in workers exposed to chlorine.
AU
Gautrin D, Leroyer C, Infante-Rivard C, Ghezzo H, Dufour JG, Girard D, Malo JL
SO
Am J Respir Crit Care Med. 1999;160(4):1232.
 
This longitudinal study (1992-1994) was performed to determine the relation between accidental chlorine exposure and changes in lung function and airway responsiveness in 239 workers in a metal production plant. These workers had taken part in a cross-sectional survey in 1992. In both the initial and the follow-up surveys, history of exposure to chlorine ("puffs"), accidental chlorine inhalation reported to the first-aid unit (gassing incidents), and of chronic symptoms were documented; spirometry and methacholine challenge tests were performed. At follow-up, 211 workers (88.3%) were seen. In workers with 20 pack-years or more of cigarette smoking, the fall in FEV(1) was associated with having had a gassing incident during the follow-up period; the fall in FEV(1)/FVC (%) was predicted by the number of puffs causing mild symptoms between the two assessments. An increase in airway responsiveness (PC(20) decrease>1.5-fold) was present in 19 workers; it was associated with accidents reported to the first-aid unit during the previous 2 yr (OR: 5.9, 95% CI: 1.1 to 32.3). These findings suggest: (1) an effect on airway function related to the estimated number of puffs with mild symptoms and gassing incidents, mostly among smokers; (2) a detectable increase in airway responsiveness associated with gassing incidents.
AD
Department of Chest Medicine, Hôpital du Sacré-Coeur, University of Montreal, Quebec, Canada. D-Gautrin@crhsc.umontreal.ca
PMID
25
TI
Functional and biological characteristics of asthma in cleaning workers.
AU
Vizcaya D, Mirabelli MC, Orriols R, AntóJM, Barreiro E, Burgos F, Arjona L, Gomez F, Zock JP
SO
Respir Med. 2013 May;107(5):673-83. Epub 2013 Feb 20.
 
OBJECTIVES: Cleaning workers have an increased risk of asthma but the underlying mechanisms are largely unknown. We studied functional and biological characteristics in asthmatic cleaners and compared these to healthy cleaners.
METHODS: Forty-two cleaners with a history of asthma and/or recent respiratory symptoms and 53 symptom-free controls were identified. Fractional exhaled nitric oxide (FeNO) was measured and forced spirometry with reversibility testing was performed. Total IgE, pulmonary surfactant protein D and the 16 kDa Clara Cell secretory protein were measured in blood serum. Interleukins and other cytokines, growth factors, cys-leukotrienes and 8-isoprostane were measured in exhaled breath condensate. Information on occupational and domestic use of cleaning products was obtained in an interview. Associations between asthma status, specific characteristics and the use of cleaning products were evaluated using multivariable linear and logistic regression analyses.
RESULTS: Asthma was associated with an 8% (95% confidence interval (CI) 1-15%) lower postbronchodilator FEV1, a higher prevalence of atopy (42% vs. 10%) and a 2.9 (CI 1.5-5.6) times higher level of total IgE. Asthma status was not associated with the other respiratory biomarkers. Most irritant products and sprays were more often used by asthmatic cleaners. The use of multiuse products, glass cleaners and polishes at work was associated with higher FeNO, particularly in controls.
CONCLUSIONS: Asthma in cleaning workers is characterised by non-reversible lung function decrement and increased total IgE. Oxidative stress, altered lung permeability and eosinophilic inflammation are unlikely to play an important underlying role, although the latter may be affected by certain irritant cleaning exposures.
AD
Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain. dvizcaya.epi@gmail.com
PMID