Occupational asthma: fate and management after the diagnosis

The clinical and socio-professional fate of subjects with occupational asthma is not univocal. We re-examined twenty-nine subjects diagnosed in our center as suffering from this disease an average 14 months, SE 1.54 after the diagnosis. At the follow-up examination each patient underwent interview, spirometry and methacholine challenge, 18 patients (group A) had ceased exposure to the sensitizing agent but among them only 7 had been relocated in another area of the plant, the others had resigned or retired. The other patients had not changed workplace, 7 (group B) having had intermittent exposure to the offending agent and 4 (group C) having continued to be exposed daily. At the follow-up examination only 9 patients were asymptomatic, each of them belonging to group A, whereas in the other 9 of the same group symptoms persisted, although reduced. In group B and C all patients were still symptomatic and required pharmacologic treatment. Within group A patients who became asymptomatic had shorter duration of symptoms before diagnosis (12.9 months, SE 6.4 vs 23.9, SE 9.7), higher FEV-1 (96.1, SE 6.7 vs 86.9, SE 5.6) and PD20FEV-1 (1773.4 micrograms, SE 590 vs 730.8, SE 295) at the time of the diagnosis and showed a significant (p < 0.01) increase in FEV-1 (from 96.1, SE 6.2 to 101.6, SE 5.5) and a tendency to decrease in bronchial reactivity to methacholine at the follow-up examination. At the time of the follow-up examination only 5 out of 29 patients (17.2%) had been contacted by the compensation board.(ABSTRACT TRUNCATED AT 250 WORDS)