Acute and long-term airway hyperreactivity in aluminium-salt exposed workers with nocturnal asthma

Nineteen young male workers exposed occupationally from 1975-1977 to inhaled particles of aluminium fluoride or sulphate at 2 plants, developed nocturnal wheezing and breathlessness with reversible airways obstruction after an average of 4 months employment. At standardized methacholine provocation tests (MPT), 17 of 19 workers with normal spirometry showed airway hyperreactivity with a fall of FEV1 of greater than or equal to 15% after 0.1% methacholine. We followed 15 initially asthmatic workers for 2-5 years with MPT. Mean TD 15% FEV1 in 11 workers did not change significantly after an average of 41 months of non-exposure. Six workers continuously exposed for 48 months also failed to change their TD 15% FEV1 MCh. In 1983, only one subject had returned to normal airway reactivity. We have no reason to suspect inducing agents other than aluminium salts.