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Occupational rhinitis in workers investigated for occupational asthma
R Castano1, D Gautrin, G Thériault
1Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. roberto.castano@mail.mcgill.ca
Thorax
|October 7, 2008
Summary
Occupational rhinitis (OR) and occupational asthma (OA) often occur together, supporting the united airways disease (UAD) model. Objective testing shows nasal and bronchial reactions frequently coexist in workers with these conditions.
Area of Science:
- Occupational medicine
- Respiratory medicine
- Immunology
Background:
- The united airways disease (UAD) model links asthma and rhinitis.
- Evidence suggests UAD applies to occupational rhinitis (OR) and occupational asthma (OA).
Purpose of the Study:
- To objectively assess the link between nasal and bronchial reactions in OR and OA using specific inhalation challenge (SIC) testing.
Main Methods:
- 43 subjects with work-related asthma symptoms underwent SIC.
- Bronchial reactivity was measured by spirometry.
- Nasal patency and inflammation were assessed via acoustic rhinometry and nasal lavage.
Main Results:
- Positive nasal challenge occurred in 25 tests; positive bronchial challenge in 17.
- Concomitant nasal and bronchial reactions were observed in 13 instances (significant association, p=0.04).
- Higher incidence of concomitant reactions with high molecular weight agents.
Conclusions:
- Study supports the UAD concept in OR and OA, demonstrating linked nasal and lung reactions.
- OR can be objectively assessed and often coexists with OA, but can occur independently.
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