title: Assessing the exacerbations risk of influenza-associated chronic occupational asthma.
abstract: The purpose of this article was to conduct a risk-based study based on a linkage of experimental human influenza infections and fluctuation analysis of airway function to assess whether influenza viral infection was risk factor for exacerbations of chronic occupational asthma. Here we provided a comprehensive probabilistic analysis aimed at quantifying influenza-associated exacerbations risk for occupational asthmatics, based on a combination of published distributions of viral shedding and symptoms scores and lung respiratory system properties characterized by long-range peak expiratory flow (PEF) dynamics. Using a coupled detrended fluctuation analysis-experimental human influenza approach, we estimated the conditional probability of moderate or severe lung airway obstruction and hence the exacerbations risk of influenza-associated occupational asthma in individuals. The long-range correlation exponent (alpha) was used as a predictor of future exacerbations risk of influenza-associated asthma. For our illustrative distribution of PEF fluctuations and influenza-induced asthma exacerbations risk relations, we found that the probability of exacerbations risk can be limited to below 50% by keeping alpha to below 0.53. This study also found that limiting wheeze scores to 0.56 yields a 75% probability of influenza-associated asthma exacerbations risk and a limit of 0.34 yields a 50% probability that may give a representative estimate of the distribution of chronic respiratory system properties. This study implicates that influenza viral infection is an important risk factor for exacerbations of chronic occupational asthma.
authors.affiliation: Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan 10617, ROC. cmliao@ntu.edu.tw
authors.forename: Chung-Min
authors.initials: CM
authors.lastname: Liao
authors.forename: Nan-Hung
authors.initials: NH
authors.lastname: Hsieh
authors.forename: Chia-Pin
authors.initials: CP
authors.lastname: Chio
authors.forename: Szu-Chieh
authors.initials: SC
authors.lastname: Chen
mesh_terms: D000465:Algorithms; D001249:Asthma / Q000209:etiology* / Q000503:physiopathology; D002908:Chronic Disease; D016208:Databases, Factual; D005541:Forced Expiratory Volume; D006801:Humans; D007251:Influenza, Human / Q000150:complications* / Q000503:physiopathology; D015233:Models, Statistical; D009784:Occupational Diseases / Q000209:etiology* / Q000503:physiopathology; D010366:Peak Expiratory Flow Rate; D012307:Risk Factors; D035501:Uncertainty
references.citation: Am J Respir Crit Care Med. 2006 Apr 15;173(8):871-6
references.pmid: 16456141
references.citation: Intensive Care Med. 2006 Jul;32(7):1022-9
references.pmid: 16791664
references.citation: Thorax. 2002 Oct;57(10):847-52
references.pmid: 12324669
references.citation: Acta Paediatr. 2002;91(7):789-92
references.pmid: 12200904
references.citation: Chest. 1998 Feb;113(2):272-7
references.pmid: 9498938
references.citation: BMJ. 1989 Apr 22;298(6680):1068-70
references.pmid: 2497892
references.citation: Thorax. 1994 Aug;49(8):775-80
references.pmid: 8091322
references.citation: Thorax. 1988 Apr;43(4):335-6
references.pmid: 3406923
references.citation: J Asthma. 2002 Aug;39(5):363-73
references.pmid: 12214890
references.citation: Am J Respir Cell Mol Biol. 2006 Nov;35(5):513-8
references.pmid: 16778148
references.citation: Am J Respir Crit Care Med. 2001 Apr;163(5):1256-76
references.pmid: 11316667
references.citation: Thorax. 1993 Dec;48(12):1211-7
references.pmid: 8303625
references.citation: Curr Opin Allergy Clin Immunol. 2007 Jun;7(3):223-30
references.pmid: 17489039
references.citation: Fundam Clin Pharmacol. 2008 Dec;22(6):633-48
references.pmid: 19049668
references.citation: Thorax. 1993 Sep;48(9):899-905
references.pmid: 8236072
references.citation: Ann Biomed Eng. 2002 May;30(5):683-92
references.pmid: 12108842
references.citation: Chest. 2006 Feb;129(2):317-324
references.pmid: 16478847
references.citation: Acta Med Scand. 1963 Feb;173:185-92
references.pmid: 13970718
references.citation: Chest. 2006 Oct;130(4):1109-16
references.pmid: 17035445
references.citation: Respiration. 2002;69(6):496-501
references.pmid: 12457001
references.citation: Phys Rev Lett. 1993 Mar 1;70(9):1343-6
references.pmid: 10054352
references.citation: J Clin Virol. 2009 Oct;46(2):129-33
references.pmid: 19665425
references.citation: Chest. 1991 Nov;100(5):1235-8
references.pmid: 1935277
references.citation: J Infect. 2006 Oct;53(4):248-54
references.pmid: 16412516
references.citation: J Clin Invest. 1998 Feb 1;101(3):643-9
references.pmid: 9449698
references.citation: Am J Respir Crit Care Med. 2006 May 15;173(10):1114-21
references.pmid: 16484677
references.citation: Lancet. 2008 Sep 20;372(9643):1088-99
references.pmid: 18805337
references.citation: Pediatrics. 2006 Aug;118(2):e347-55
references.pmid: 16864642
references.citation: Nature. 2005 Dec 1;438(7068):667-70
references.pmid: 16319891
references.citation: Chest. 2007 Jan;131(1):44-52
references.pmid: 17218555
references.citation: Chest. 2006 Oct;130(4):1203-10
references.pmid: 17035457
references.citation: Am J Epidemiol. 2008 Apr 1;167(7):775-85
references.pmid: 18230677
references.citation: Curr Opin Pulm Med. 2008 Mar;14(2):89-94
references.pmid: 18303415
references.citation: Allergy. 1993;48(17 Suppl):57-61; discussion 62-4
references.pmid: 8109714
references.citation: BMC Pulm Med. 2009 Jan 29;9:7
references.pmid: 19178702
references.citation: J Electrocardiol. 1995;28 Suppl:59-65
references.pmid: 8656130
references.citation: Am J Respir Crit Care Med. 1998 Sep;158(3):827-32
references.pmid: 9731012
references.citation: Thorax. 2006 Sep;61(9):809-16
references.pmid: 16936237
references.citation: Eur Respir J. 2001 Dec;18(6):921-7
references.pmid: 11829097
references.citation: J Virol. 2006 Aug;80(15):7590-9
references.pmid: 16840338
references.citation: Epidemiol Infect. 2006 Dec;134(6):1174-8
references.pmid: 16623988