Long-term outcomes of acute irritant-induced asthma.
BACKGROUND
The long-term outcomes of acute irritant-induced asthma (IIA) are mostly unknown.


OBJECTIVE
To study the long-term outcomes of IIA.


METHODS
We reassessed 35 subjects who experienced IIA at a mean interval of 13.6 +/- 5.2 years.


RESULTS
The causal agent was chlorine in 20 cases (57%). At diagnosis, the mean +/- SD FEV(1) was 74.5 +/- 19.5% predicted, and all subjects showed bronchial hyperresponsiveness. At reassessment, all subjects reported respiratory symptoms, and 24 (68%) were on inhaled steroids. There were no significant improvements in FEV(1) and FEV(1)/FVC values. Twenty-three subjects had a methacholine test, and only six subjects had normal levels of responsiveness. Of the remaining 12 subjects, six had improvement in FEV(1) after bronchodilator >or=10%. In samples of induced sputum obtained from 27 subjects, six had eosinophils >or=2%. Levels of inflammatory and remodeling mediators were higher than in control subjects but were no different from subjects with occupational asthma due to sensitization. Quality of life score was 4.4 +/- 1.5 on a 0 (worst) to 7 (best) scale. Twelve subjects had an abnormal depression score.


CONCLUSIONS
This study provides the first evidence of significant long-term impact of acute IIA on various outcomes.
Malo
Jean-Luc
JL
Axe de Recherche en Santé Respiratoire, Hôpital du Sacré-Coeur de Montréal, Quebec. malojl@meddir.umontreal.ca
L'archevêque
Jocelyne
J
Castellanos
Lucero
L
Lavoie
Kim
K
Ghezzo
Heberto
H
Maghni
Karim
K
D000062:Accidents, Occupational; D000328:Adult; D001249:Asthma / Q000139:chemically induced* / Q000503:physiopathology / Q000523:psychology; D016535:Bronchial Hyperreactivity / Q000139:chemically induced / Q000503:physiopathology / Q000523:psychology; D002713:Chlorine / Q000506:poisoning*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects; D007509:Irritants / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000503:physiopathology / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects; D013183:Sputum / Q000737:chemistry / Q000166:cytology; D016896:Treatment Outcome
D007509:Irritants; D002713:Chlorine