RT Journal Article
SR Electronic
T1 Prognosis of occupational asthma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 761
OP 767
DO 10.1183/09031936.94.07040761
VO 7
IS 4
A1 PL Paggiaro
A1 B Vagaggini
A1 E Bacci
A1 L Bancalari
A1 M Carrara
A1 A Di Franco
A1 D Giannini
A1 FL Dente
A1 C Giuntini
YR 1994
UL http://erj.ersjournals.com/content/7/4/761.abstract
AB Several studies on the prognosis of occupational asthma have shown that a significant proportion of patients continue to experience asthmatic symptoms and nonspecific bronchial hyperresponsiveness after cessation of work. The determinants of this unfavourable prognosis of asthma are: long duration of exposure before the onset of asthma; long duration of symptoms before diagnosis; baseline airway obstruction; dual response after specific challenge test; and the persistence of markers of airway inflammation in bronchoalveolar lavage fluid and bronchial biopsy. The relevance of immunological markers in the outcome of occupational asthma has not yet been assessed. Further occupational exposure in sensitized subjects leads to persistence and sometimes to progressive deterioration of asthma, irrespective of the reduction of exposure to the specific sensitizer, and only the use of particular protective devices effectively prevents the progression of the disease. A long-term follow-up study of toluene diisocyanate (TDI)-induced asthma showed that the improvement in bronchial hyperresponsiveness to methacholine occurred in a small percentage of subjects and only a long time after work cessation. Bronchial sensitivity to TDI may disappear, but non-specific bronchial hyperresponsiveness often persists unchanged, suggesting a permanent deregulation of airway tone. Steroid treatment significantly reduces nonspecific bronchial hyperresponsiveness only when started immediately after diagnosis.