Assessment of impairment/disability due to occupational asthma through a multidimensional approach

¹ Dept of Chest Medicine, Hôpital du Sacré-Cur de Montréal, 5400 Gouin West, Montreal, Quebec H4J 1C5, Canada

^* To whom correspondence should be addressed. E-mail: malojl{at}meddir.umontreal.ca.

	Abstract

Subjects with occupational asthma (OA) are often left with permanent sequelae after removal from exposure. Assessing impairment/disability should utilize various tools. Aims: Examine whether: 1) assessment of inflammation in induced sputum is relevant to impairment; and 2) use of questionnaires on quality of life and psychological factors can be useful to the evaluation of disability. 40 subjects were prospectively assessed for permanent impairment/disability due to OA two years after cessation of exposure. Impairment was assessed as follows: 1) need for asthma medication; 2) asthma severity; 3) airway calibre and responsiveness; and 4) degree of inflammation in induced sputum. Disability was assessed according to quality of life and psychological distress. There was a significant improvement in airway responsiveness and inflammation from diagnosis to the present assessment. Sputum eosinophils 2% and neutrophils > 60% were present in 8 (20%) and 12 (30%) of subjects, one or the other feature being the only abnormalities in 15% of subjects. Quality of life was moderately affected and there was a prevalence close to 50% of depression and anxiety. In the assessment of subjects with OA, information on airway inflammation and psychological impacts are relevant to the assessment of impairment/disability although these findings need further investigation.

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