Chemosensory irritation and the lung.
Airway irritation involves a variety of reflex mechanisms. Tracheal and bronchial C fibres and rapidly adapting fibres mediate cough, bronchoconstriction, and mucosal vasodilation. Workplace respiratory irritants can have a variety of effects in relation to asthma. Very high exposures can cause new-onset asthma, clinically presenting as reactive airways dysfunction syndrome or irritant-induced asthma. Symptoms after exposure to irritants depend on aggregate characteristics, water solubility and dose. Measurement of pulmonary function in response to irritants includes baseline spirometry, monitoring of across-shift changes and changes in non-specific bronchial responsiveness as well as bronchial responsiveness to inhaled allergens. Following irritant exposure, inflammatory changes within the airways are monitored by bronchoalveolar lavage or - less invasively - by sputum markers. A completely non-invasive approach not limited in repeatability is the investigation of inflammatory markers in exhaled air. However, the diagnostic and prognostic values of these novel markers have still to be demonstrated.
Nowak
Dennis
D
Institute and Outpatient Clinic for Occupational and Environmental Medicine, Ludwig-Maximilians-University, Ziemssenstrasse 1, 80336 München, Germany. Dennis.Nowak@arbeits.med.uni-muenchen.de
D000818:Animals; D001249:Asthma / Q000139:chemically induced; D016535:Bronchial Hyperreactivity / Q000139:chemically induced; D018893:Bronchoalveolar Lavage; D006801:Humans; D019570:Inhalation Exposure; D007509:Irritants / Q000009:adverse effects*; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D009784:Occupational Diseases / Q000139:chemically induced*; D011014:Pneumonia / Q000139:chemically induced*
D007509:Irritants