Reactive Airways Dysfunction Syndrome and Irritant-Induced Asthma

Gautrin, Denyse; Brooks, Stuart M.; Henneberger, Paul K.

doi:10.3109/9780849374531-26

Cited by 22 publications

(20 citation statements)

References 157 publications

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“…Also, increased thickness of the basement membrane in IrIa compared with asthma further emphasizes this distinctive characteristic of IrIa-that is, increased remodeling. 2 The chronic inflammation and subepithelial fibrosis in turn may lead to persistent symptoms and AHR. Consequently, as for asthma, anti-inflammatory treatment with inhaled steroids should be strongly recommended.…”

Section: Discussionmentioning

confidence: 99%

Long-term pathologic consequences of acute irritant-induced asthma

Takeda

Maghni

Daigle

et al. 2009

Journal of Allergy and Clinical Immunology

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Section: Discussionmentioning

confidence: 99%

Long-term pathologic consequences of acute irritant-induced asthma

Takeda

Maghni

Daigle

et al. 2009

Journal of Allergy and Clinical Immunology

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“…Inhalation accidents may occur at home (25), in the workplace (14,21,26,27), or in the general environment (28,29). There is common agreement that RADS is best described as non-immunological occupational asthma without a latency period, occurring after a single exposure to airway irritants and should be distinguished from the more commonly observed occupational asthma, which has in many cases an underlying immunologic mechanism characterized by sensitization (30). Most of the highly exposed subjects emphasized the irritant nature of the combustion products.…”

Section: Discussionmentioning

confidence: 99%

Respiratory effects in the aftermath of a major fire in a chemical waste depot

Greven¹,

Kerstjens

Duijm³

et al. 2009

Scand J Work Environ Health

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Objective The aim of this study was to investigate respiratory effects among emergency services first responders and residents exposed to combustion products in the aftermath of a chemical waste depot fire.Methods The study population comprised 138 individuals who were present in the area downwind of an accidental fire. Identified by telephone interview six years later, subjects with persistent respiratory symptoms were suspected as having Reactive Airways Dysfunction Syndrome (RADS). Medical tests were performed. For bronchial responsiveness, a cut-off point of PD 20 <2.39 mg histamine was taken and a dose-response slope (DRS) was calculated. Suspected RADS cases were compared with healthy controls for exposure to combustion products, lung function, and bronchial responsiveness. ResultsThe 25 suspected RADS cases were more frequently exposed than the 99 controls; the crude odds ratio for high versus low exposure was 6.5 [95% confidence interval (95% CI) 2.4-18.0]. Suspected cases showed a lower ratio of forced expiratory volume in one second to forced vital capacity (FEV 1 /FVC; P=0.028). Overall, suspected cases had a higher DRS than controls. The difference was significant for males only (P=0.006), and non-smoking males (P=0.014). Highly exposed subjects had a higher DRS than low exposed subjects (P=0.056). These differences were significant when restricted to non-smokers (P=0.034) and males (P=0.019). Differences between cases and controls were stronger when the population was restricted to current non-smokers.Conclusions Persistent respiratory symptoms and bronchial responsiveness were associated with exposure to combustion products of a chemical waste depot fire which occurred more than six years earlier. Authorities and emergency services are recommended to take this into consideration when managing incidents in order to limit possible exposure to airway irritants.

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“…The primary respiratory outcome was a self-reported first lifetime diagnosis of asthma or reactive airways dysfunction syndrome after September 11, collectively referred to as "asthma." 28 Participants reported whether they were ever diagnosed by a physician as having asthma or reactive airways dysfunction syndrome, the year of diagnosis, and, if in 2001, whether diagnosis occurred before or after September 11. Postevent asthma was further categorized as early, late, or unknown date of diagnosis.…”

Section: Study Variablesmentioning

confidence: 99%

Asthma and Posttraumatic Stress Symptoms 5 to 6 Years Following Exposure to the World Trade Center Terrorist Attack

Brackbill

Hadler

DiGrande

et al. 2009

JAMA

315

450

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Context The World Trade Center Health Registry provides a unique opportunity to examine long-term health effects of a large-scale disaster. Objective To examine risk factors for new asthma diagnoses and event-related posttraumatic stress (PTS) symptoms among exposed adults 5 to 6 years following exposure to the September 11, 2001, World Trade Center (WTC) terrorist attack. Design, Setting, and Participants Longitudinal cohort study with wave 1 (W1) enrollment of 71 437 adults in 2003-2004, including rescue/recovery worker, lower Manhattan resident, lower Manhattan office worker, and passersby eligibility groups; 46 322 adults (68%) completed the wave 2 (W2) survey in 2006-2007.Main Outcome Measures Self-reported diagnosed asthma following September 11; event-related current PTS symptoms indicative of probable posttraumatic stress disorder (PTSD), assessed using the PTSD Checklist (cutoff score Ն44). ResultsOf W2 participants with no stated asthma history, 10.2% (95% confidence interval [CI], 9.9%-10.5%) reported new asthma diagnoses postevent. Intense dust cloud exposure on September 11 was a major contributor to new asthma diagnoses for all eligibility groups: for example, 19.1% vs 9.6% in those without exposure among rescue/ recovery workers (adjusted odds ratio, 1.5 [95% CI, 1.4-1.7]). Asthma risk was highest among rescue/recovery workers on the WTC pile on September 11 (20.5% [95% CI, 19.0%-22.0%]). Persistent risks included working longer at the WTC site, not evacuating homes, and experiencing a heavy layer of dust in home or office. Of participants with no PTSD history, 23.8% (95% CI, 23.4%-24.2%) reported PTS symptoms at either W1 (14.3%) or W2 (19.1%). Nearly 10% (9.6% [95% CI, 9.3%-9.8%]) had PTS symptoms at both surveys, 4.7% (95% CI, 4.5%-4.9%) had PTS symptoms at W1 only, and 9.5% (95% CI, 9.3%-9.8%) had PTS symptoms at W2 only. At W2, passersby had the highest rate of PTS symptoms (23.2% [95% CI, 21.4%-25.0%]). Event-related loss of spouse or job was associated with PTS symptoms at W2. ConclusionAcute and prolonged exposures were both associated with a large burden of asthma and PTS symptoms 5 to 6 years after the September 11 WTC attack.

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Reactive Airways Dysfunction Syndrome and Irritant-Induced Asthma

Cited by 22 publications

References 157 publications

Long-term pathologic consequences of acute irritant-induced asthma

Long-term pathologic consequences of acute irritant-induced asthma

Respiratory effects in the aftermath of a major fire in a chemical waste depot

Asthma and Posttraumatic Stress Symptoms 5 to 6 Years Following Exposure to the World Trade Center Terrorist Attack

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