Occupational Asthma Reference

Talini D, Novelli F, Melosini L, Bacci E, Bartoli ML, Cianchetti S, Dente FL, Di Franco A, Vagaggini B, Paggiaro PL, May the reduction of exposure to specific sensitizers be an alternative to work cessation in occupational asthma? Results from a follow-up study., Int Arch Allergy Immunol, 2012;157:186-193,

Keywords: italy, follow-up, nsbr, oa, challenge,FEV1

Known Authors

Pierluigi Paggiaro, Ospedale Cisanello, Pisa, Italy Pierluigi Paggiaro

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Few data are reported on the effects of a reduction of exposure to specific sensitizers in occupational asthma (OA).
The objective of this study was to evaluate the clinical outcome of subjects with OA, comparing the effect of a reduction with that of the persistence or cessation of occupational exposure to the specific sensitizer.

Forty-one subjects with OA due to different sensitizers were diagnosed via a specific inhalation challenge.
After a follow-up interval of 3.5 years, subjects were reexamined by clinical assessment, bronchial hyperresponsiveness (BH) and induced sputum.

At follow-up, subjects who had reduced occupational exposure (n=2) showed a significant improvement in BH and a nonsignificant improvement in sputum eosinophilia (from 5.3 to 1.1%, n.s.), while subjects still exposed (n=10) showed a significant decrease in FEV(1). Subjects who ceased work (n=9) showed a trend of improvement in BH and sputum eosinophilia.Logistic analysis showed that the major determinant of improvement in BH at follow-up was the severity of BH at diagnosis, with a minimal contribution from the duration of exposure and treatment with inhaled corticosteroids during follow-up; reduction of work exposure did not enter into any model.

The reduction of occupational exposure could not be considered to be as effective as work cessation, which remained the best treatment for OA.
However, it was not associated with a deterioration of FEV(1) as observed in subjects with persistent exposure.

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