Medline ® Abstracts for References 41,43,44,57-60

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

41
TI
Persistent asthma after repeated exposure to high concentrations of gases in pulpmills.
AU
Chang-Yeung M, Lam S, Kennedy SM, Frew AJ
SO
Am J Respir Crit Care Med. 1994;149(6):1676.
 
This is a clinicopathologic study of three subjects with irritant-induced asthma. They were pulpmill workers who had a history of multiple "gassing" episodes that occurred over a period of years. Persistent symptoms of asthma and nonspecific bronchial hyperresponsiveness and/or variable airflow obstruction occurred after at least one episode of "gassing," resulting in symptoms severe enough to require emergency room treatment. One of the three subjects had normal spirometry values before he entered the pulpmill. Bronchial biopsy done on these subjects showed changes compatible with asthma, including thickened basement membrane in two and cellular infiltration with activated eosinophils and mononuclear cells in all three. The results of immunohistology of bronchial mucosal biopsy of these subjects were compared with those of patients with allergic asthma and patients with Western red cedar-induced asthma. Subjects with irritant-induced asthma had a greater density of activated eosinophils and fewer T-lymphocytes, suggesting that cell-mediated immune mechanisms are not involved in the pathogenesis of this condition.
AD
Department of Medicine, University of British Columbia, Vancouver General Hospital, Canada.
PMID
43
TI
AEOL10150: a novel therapeutic for rescue treatment after toxic gas lung injury.
AU
McGovern T, Day BJ, White CW, Powell WS, Martin JG
SO
Free Radic Biol Med. 2011 Mar;50(5):602-8. Epub 2010 Dec 13.
 
New therapeutics designed as rescue treatments after toxic gas injury such as from chlorine (Cl(2)) are an emerging area of interest. We tested the effects of the metalloporphyrin catalytic antioxidant AEOL10150, a compound that scavenges peroxynitrite, inhibits lipid peroxidation, and has SOD and catalase-like activities, on Cl(2)-induced airway injury. Balb/C mice received 100ppm Cl(2) gas for 5 min. Four groups were studied: Cl(2) only, Cl(2) followed by AEOL10150 1 and 9 h after exposure, AEOL10150 only, and control. Twenty-four hours after Cl(2) gas exposure airway responsiveness to aerosolized methacholine (6.25-50mg/ml) was measured using a small-animal ventilator. Bronchoalveolar lavage (BAL) was performed to assess airway inflammation and protein. Whole lung tissue was assayed for 4-hydroxynonenal. In separate groups, lungs were collected at 72 h after Cl(2) injury to evaluate epithelial cell proliferation. Mice exposed to Cl(2) showed a significantly higher airway resistance compared to control, Cl(2)/AEOL10150, or AEOL10150-only treated animals in response to methacholine challenge. Eosinophils, neutrophils, and macrophages were elevated in BAL of Cl(2)-exposed mice. AEOL10150 attenuated the increases in neutrophils and macrophages. AEOL10150 prevented Cl(2)-induced increase in BAL fluid protein. Chlorine induced an increase in the number of proliferating airwayepithelial cells, an effect AEOL10150 attenuated. 4-Hydroxynonenal levels in the lung were increased after Cl(2) and this effect was prevented with AEOL10150. AEOL10150 is an effective rescue treatment for Cl(2)-induced airway hyperresponsiveness, airway inflammation, injury-induced airway epithelial cell regeneration, and oxidative stress.
AD
Meakins Christie Laboratories, Department of Medicine, McGill University, Montreal, QC H2X 2P2, Canada.
PMID
44
TI
Persistent respiratory health effects after a metam sodium pesticide spill.
AU
Cone JE, Wugofski L, Balmes JR, Das R, Bowler R, Alexeeff G, Shusterman D
SO
Chest. 1994;106(2):500.
 
STUDY OBJECTIVE: To report the occurrence of persistent respiratory disorders, including irritant-induced asthma, among adults living and working near an environmental spill of the pesticide, metam sodium, after the derailment of a tank car.
DESIGN: Retrospective clinical case series.
SETTING: California communities situated within one-half mile of the Sacramento River, from Mt. Shasta City to Shasta Lake.
PATIENTS: 197 adults referred to a university occupational/environmental health clinic or to a private occupational/environmental health practitioner for evaluation of health problems potentially related to the spill.
MEASUREMENTS AND RESULTS: History, physical examination, review of medical records, spirometry, and methacholine challenge testing revealed 20 cases of persistent irritant-induced asthma and 10 cases of persistent exacerbation of asthma.
CONCLUSIONS: This is the first reported series of cases of persistent irritant-induced asthma involving both community residents and occupationally exposed individuals.
AD
Department of Medicine, University of California, San Francisco, USA.
PMID
57
TI
Asthma characteristics in cleaning workers, workers in other risk jobs and office workers.
AU
Zock JP, Kogevinas M, Sunyer J, Jarvis D, Torén K, AntóJM, European Community Respiratory Health Survey
SO
Eur Respir J. 2002;20(3):679.
 
Several studies have demonstrated an excess risk for asthma among cleaning workers. The aim of this analysis was to compare clinical, immunological and functional characteristics associated with asthma in cleaners and other occupational groups. Cleaners, workers exposed to high molecular weight (MW) agents, workers exposed to low MW agents, and office workers were identified from an international community-based epidemiological study. Influence of sex, smoking, age and atopy on the relationships with asthma was investigated. Rates of respiratory symptoms, bronchial hyperresponsiveness, atopic sensitisation and lung function were compared between asthmatics from the four groups (case-case analysis). The risk for asthma in workers exposed to low MW agents was higher among nonatopics than among atopics. Case-case analysis showed no major differences in asthma characteristics between cleaners and workers exposed to high or low MW agents. Asthmatic cleaners had less atopy, more chronic bronchitis and a lower lung function as compared to office workers. Asthma in cleaning workers showed many similarities with that in workers known to be at risk for occupational asthma. Atopic sensitisation did not seem to play an important role in cleaning-related asthma.
AD
Respiratory and Environmental Health Research Unit, Institut Municipal d'lnvestigacióMèdica, Barcelona, Spain. jpzock@imim.es
PMID
58
TI
Irritant-associated vocal cord dysfunction.
AU
Perkner JJ, Fennelly KP, Balkissoon R, Bartelson BB, Ruttenber AJ, Wood RP 2nd, Newman LS
SO
J Occup Environ Med. 1998;40(2):136.
 
Vocal cord dysfunction (VCD) is a poorly understood entity that is often misdiagnosed as asthma. We report eleven cases of VCD in which there was a temporal association between VCD onset and occupational or environmental exposure. We conducted a case-control study to determine if the characteristics of irritant-exposed VCD (IVCD) cases differed from non-exposed VCD controls. Chart review of VCD patients at the authors' institution produced 11 cases that met IVCD case criteria. Thirty-three control VCD subjects were selected by age matching. There were statistical differences between the groups in ethnicity and chest discomfort. There were no statistical differences between the groups for gender, tobacco, smoking habits, symptoms, or pulmonary function parameters. Varied irritant exposures were associated with IVCD. IVCD should be considered in patients presenting with respiratory symptoms occurring after irritant exposures.
AD
Department of Medicine, National Jewish Medical and Research Center, Denver, CO 80206, USA.
PMID
59
TI
Eosinophilic bronchitis in the workplace.
AU
Quirce S
SO
Curr Opin Allergy Clin Immunol. 2004;4(2):87.
 
PURPOSE OF REVIEW: The purpose of this review is to report that eosinophilic bronchitis without asthma may occur as an occupational airway disease. This condition is characterized by cough that is responsive to corticosteroids and eosinophilia detectable in the sputum, without variable airflow obstruction or airway hyperresponsiveness.
RECENT FINDINGS: Eosinophilic bronchitis can be regarded as an occupational respiratory disorder when it develops as a consequence of work exposures. Recently, exposure to certain occupational allergens or sensitizers, such as natural rubber latex, mushroom spores, acrylates and an epoxy resin hardener, have been reported to cause eosinophilic bronchitis without asthma. Several hypotheses have been put forward trying to explain why patients with eosinophilic bronchitis do not have airway hyperresponsiveness. It is unknown whether eosinophilic bronchitis may progress to typical occupational asthma, or if eosinophilic airway inflammation may persist when asthma symptoms and airway hyperresponsiveness have waned after the cessation of exposure to the occupational agent.
SUMMARY: Eosinophilic bronchitis, like asthma, may arise from occupational exposures. The examination of induced sputum should be added to the objective monitoring of lung function during periods at work and away from work, as well as before and after specific inhalation challenges with occupational agents.
AD
Fundación Jiménez Díaz, Allergy Department, Madrid, Spain. sequirce@fjd.es
PMID
60
TI
Workplace-related chronic cough on a mushroom farm.
AU
Tanaka H, Saikai T, Sugawara H, Takeya I, Tsunematsu K, Matsuura A, Abe S
SO
Chest. 2002;122(3):1080.
 
BACKGROUND: Mushroom spores have frequently been associated with respiratory allergy. The aims of this study were to elucidate the incidence and causes of chronic cough in a mushroom farm.
METHODS: Participants were 69 mushroom workers who produce Hypsizigus marmoreus (Bunashimeji) and 35 control subjects. We excluded six workers because they had had asthma or allergic rhinitis before working. Participants completed a cross-sectional health survey 2 years after starting work at the mushroom farm.
RESULTS: The mean airborne endotoxin levels in the harvesting and packing rooms were approximately 60-fold higher than those in the offices. Of 63 workers, 42 workers (67%) reported chronic cough after working on this farm, 19 workers had no cough, while 2 workers had hypersensitivity pneumonitis develop to the spore, which has been previously reported by us. Of the 42 workers with cough, 6 workers had organic dust toxic syndrome (ODTS), 18 workers had postnasal drip syndrome, 15 workers had cough variant asthma, and 3 workers had eosinophilic bronchitis. Seventy-one percent of the workers noticed the cough in the first 3 months, and the mean latent period in ODTS workers was the shortest. The cough had a trend to improve or disappear after weekend holidays. Bronchial hyperresponsiveness but not FEV(1)/FVC% in the 42 workers with cough was significantly (p<0.001) increased as compared with the control subjects.
CONCLUSIONS: Working on a mushroom farm carries a significant risk for chronic cough from inhalation of mushroom spores, and we suggest that elevated airborne endotoxin on this farm is the cause.
AD
Third Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan. tanakah@sapmed.ac.jp
PMID