Reactive airway disease in patients with prolonged exposure to industrial solvents

This study examines the effects of volatile organic compounds (VOCs) at the workplace on pulmonary function tests. Forty-two patients with a history of industrial exposure to organic solvents and pulmonary symptomatology were studied. Lung function tests were determined utilizing screening spirometry lung volumes, diffusion capacity and methacholine stimulation test. While only 10-15% of the symptomatic patients had abnormal screening spirometry, 42% of the patients had significantly abnormal methacholine stimulation tests. These data show that exposure to volatile organic solvents is associated with bronchial hyperreactivity not commonly detected by screening spirometry and requires methacholine stimulation testing in individuals with unexplained symptomatology and history of exposure to industrial solvents. These findings indicate that the incidence of bronchial hyperreactivity is underestimated in patients with (1) verifiable exposure history to volatile organic compounds known to be pulmonary irritants, (2) pulmonary symptomatology with normal screening spirometry.