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Which agents cause reactive airways dysfunction syndrome (RADS)? A systematic review
M S Shakeri1, F D Dick, J G Ayres
1Department of Occupational Heath, Province Health Centre, Mazandaran University of Medical Science, Sari, Iran.
Reactive airways dysfunction syndrome (RADS) is often linked to workplace chemical exposures like chlorine. However, studies lack detailed information on causative agents and outcomes, necessitating a structured data collection approach.
Area of Science:
- Occupational Medicine
- Pulmonary Toxicology
- Environmental Health
Background:
- Reactive airways dysfunction syndrome (RADS) is a non-immunologic asthma-like condition.
- It is typically triggered by a single, high-level exposure to an irritant gas, fume, or vapor.
- Understanding the causative agents and long-term outcomes is crucial for diagnosis and management.
Purpose of the Study:
- To systematically identify agents reported to cause reactive airways dysfunction syndrome (RADS).
- To assess the quality of available information regarding exposures, investigations, and outcomes in RADS cases.
Main Methods:
- A systematic literature review was conducted.
- Abstracts were screened for relevance.
- Selected articles were reviewed against predefined diagnostic criteria for RADS.
Main Results:
- Significant information gaps were identified across all assessed measures.
- The causative agent was frequently unreported.
- Commonly reported agents included chlorine, toluene di-isocyanate (TDI), and oxides of nitrogen.
- Most exposures occurred in occupational settings, predominantly affecting men.
- Dyspnea and cough were the most frequent symptoms, with a median duration of 13 months.
Conclusions:
- Chlorine was the most frequently reported agent associated with RADS.
- A general lack of adequate information on exposure, investigation, and patient outcomes was a key finding.
- A more structured approach and a minimum data set are proposed for better RADS case reporting and research.
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