title: Longitudinal assessment of airway caliber and responsiveness in workers exposed to chlorine.
abstract: 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.
authors.affiliation: Department of Chest Medicine, Hôpital du Sacré-Coeur, University of Montreal, Quebec, Canada. D-Gautrin@crhsc.umontreal.ca
authors.forename: D
authors.initials: D
authors.lastname: Gautrin
authors.forename: C
authors.initials: C
authors.lastname: Leroyer
authors.forename: C
authors.initials: C
authors.lastname: Infante-Rivard
authors.forename: H
authors.initials: H
authors.lastname: Ghezzo
authors.forename: J G
authors.initials: JG
authors.lastname: Dufour
authors.forename: D
authors.initials: D
authors.lastname: Girard
authors.forename: J L
authors.initials: JL
authors.lastname: Malo
mesh_terms: D000062:Accidents, Occupational; D016535:Bronchial Hyperreactivity / Q000139:chemically induced*; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents / Q000494:pharmacology; D002713:Chlorine / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D019570:Inhalation Exposure; D008137:Longitudinal Studies; D008297:Male; D008669:Metallurgy; D016210:Methacholine Chloride; D008875:Middle Aged; D016273:Occupational Exposure; D012120:Respiration Disorders / Q000139:chemically induced* / Q000175:diagnosis; D012907:Smoking; D013147:Spirometry; D014797:Vital Capacity
chemical_list: D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride; D002713:Chlorine