title: Assessment of impairment/disability due to occupational asthma through a multidimensional approach.
abstract: Subjects with occupational asthma (OA) are often left with permanent sequelae after removal from exposure, and assessing their impairment/disability should utilise various tools. The aim of the present study was to examine whether: 1) assessment of inflammation in induced sputum is relevant to impairment; and 2) use of questionnaires on quality of life and psychological factors can be useful for the evaluation of disability. In total, 40 subjects were prospectively assessed for permanent impairment/disability due to OA 2 yrs after cessation of exposure. Impairment was assessed as follows: 1) need for asthma medication; 2) asthma severity; 3) airway calibre and responsiveness; and 4) degree of inflammation in induced sputum. Disability was assessed according to quality of life and psychological distress. There was a significant improvement in airway responsiveness and inflammation from diagnosis to the present assessment. Sputum eosinophils > or =2% and neutrophils >60% were present in eight (20%) and 12 (30%) out of all subjects, respectively, one or the other feature being the only abnormalities in 15% of subjects. Quality of life was moderately affected and there was a prevalence of depression and anxiety close to 50%. In the assessment of subjects with occupational asthma, information on airway inflammation and psychological impacts are relevant to the assessment of impairment/disability, although these findings need further investigation.
authors.affiliation: Dept of Chest Medicine, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin West, Montreal, QC, H4J 1C5, Canada.
authors.forename: M-R
authors.initials: MR
authors.lastname: Yacoub
authors.forename: K
authors.initials: K
authors.lastname: Lavoie
authors.forename: G
authors.initials: G
authors.lastname: Lacoste
authors.forename: S
authors.initials: S
authors.lastname: Daigle
authors.forename: J
authors.initials: J
authors.lastname: L'archevêque
authors.forename: H
authors.initials: H
authors.lastname: Ghezzo
authors.forename: C
authors.initials: C
authors.lastname: Lemière
authors.forename: J-L
authors.initials: JL
authors.lastname: Malo
mesh_terms: D000704:Analysis of Variance; D001249:Asthma / Q000503:physiopathology* / Q000523:psychology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000503:physiopathology* / Q000523:psychology*; D016273:Occupational Exposure / Q000009:adverse effects; D011788:Quality of Life; D012044:Regression Analysis; D012129:Respiratory Function Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D013183:Sputum / Q000166:cytology; D011795:Surveys and Questionnaires