title: Occupational asthma caused by natural rubber latex: outcome according to cessation or reduction of exposure.
abstract: BACKGROUND
  The long-term effects of reducing exposure to latex in subjects with latex-induced asthma remain unknown.
  
  
  OBJECTIVE
  The purpose of this study was to compare the health and socioeconomic outcomes of subjects with latex-induced asthma before and after reduction or cessation of exposure to latex.
  
  
  METHODS
  Thirty-six subjects with latex-induced asthma as ascertained by specific inhalation challenges were investigated after a median follow-up of 56 months (range, 12 to 92 months). Initial and follow-up visits included use of a detailed questionnaire and measurement of the concentration of histamine causing a 20% fall in FEV(1) (PC(20)). At follow-up, information on employment, financial status, and quality of life was collected.
  
  
  RESULTS
  At follow-up, 16 subjects were no longer exposed to latex, whereas 20 subjects had reduced exposure. In the subjects who avoided exposure, asthma severity decreased from a median score of 8.5 to 3.5 (P =.001) and the median histamine PC(20) value increased from 0.4 mg/mL to 2.3 mg/mL (P =.002). In the subjects who reduced their exposure, asthma-severity score improved from 6.5 to 2.5 (P <.001) and PC(20) values rose from 0.5 mg/mL to 2.4 mg/mL (P <.001). Cessation of exposure to latex was associated with asthma-related work disability (69%) and loss of income (62%) more frequently than was reduction of exposure (35% and 30%, respectively).
  
  
  CONCLUSIONS
  Reduction of exposure to latex should be considered a reasonably safe alternative that is associated with fewer socioeconomic consequences than removal from exposure.
authors.affiliation: Service de Pneumologie and Centre de Biostatistique et de Documentation Médicale, Cliniques Universitaires de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Vandenplas
authors.forename: Jacques
authors.initials: J
authors.lastname: Jamart
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Delwiche
authors.forename: Geneviève
authors.initials: G
authors.lastname: Evrard
authors.forename: Alexandra
authors.initials: A
authors.lastname: Larbanois
mesh_terms: D000328:Adult; D001249:Asthma / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007840:Latex / Q000009:adverse effects*; D008297:Male; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D016273:Occupational Exposure; D011788:Quality of Life; D012959:Socioeconomic Factors
chemical_list: D007840:Latex