Rhinitis in subjects with work-exacerbated asthma.
OBJECTIVE
This study aimed at characterizing the nature, severity, and timing of nasal and ocular symptoms in subjects with work-exacerbated asthma (WEA).


METHODS
Among the 363 subjects referred to a tertiary-care hospital for the investigation of work-related asthma symptoms, 105 subjects who demonstrated non-specific bronchial hyperresponsiveness to histamine, but a negative response to a specific inhalation challenge with the suspected occupational agent(s) were considered as having WEA. Their characteristics were compared with those of 172 subjects with occupational asthma (OA), ascertained by a positive response to a specific inhalation challenge.


RESULTS
A high proportion of subjects with WEA (83%) and OA (90%) reported at least one nasal symptom at work. Sneezing/itching and rhinorrhea were more frequent in subjects with OA (78% and 70%, respectively) than in those with WEA (61%, p = 0.004 and 57%, p = 0.038, respectively), while post-nasal discharge was more common in WEA (30%) than in OA (18%, p = 0.019). Nasal symptoms were less severe in WEA (median [25th-75th percentiles] global severity score: 4 [2-6]) as compared to OA (5 [4-7], p < 0.001). Nasal symptoms preceded less frequently those of asthma in subjects with WEA (17%) than in subjects with OA (43%, p = 0.001).


CONCLUSIONS
Nasal symptoms are highly prevalent in subjects with WEA, although their clinical pattern differs from that found in OA. Further investigations of the health and socio-economic impacts of upper airways symptoms in WEA are required to improve the understanding and management of this common condition.
Vandenplas
Olivier
O
Department of Chest Medicine, Mont-Godinne Hospital; Université Catholique de Louvain, B-5530 Yvoir, Belgium. olivier.vandenplas@uclouvain.be
Van Brussel
Philippe
P
D'Alpaos
Vinciane
V
Wattiez
Mathieu
M
Jamart
Jacques
J
Thimpont
Joël
J
D000328:Adult; D000485:Allergens; D001249:Asthma / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D001530:Belgium / Q000453:epidemiology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D055556:Nasal Lavage; D009784:Occupational Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D012220:Rhinitis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012720:Severity of Illness Index; D012882:Skin Tests; D011795:Surveys and Questionnaires
D000485:Allergens