Reactive Airways Dysfunction Syndrome

Alberts, W. Michael; Picó, Guillermo

doi:10.1378/chest.109.6.1618

Cited by 111 publications

(44 citation statements)

References 39 publications

(1 reference statement)

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“…The onset is abrupt and unassociated with preceding ocular or upper airway symptoms. 23 Many of the agents incriminated in the induction of RADS are gases that are soluble in water. Depending on the corrosive properties of the agent, its concentration, and the duration of exposure, one might have ocular, skin, and mucous membrane burns causing acute inflammatory bronchoconstriction.…”

Section: Pathogenesis Of Oamentioning

confidence: 99%

“…The American College of Chest Physicians has published a set of consensus diagnostic criteria that include (1) absence of prior chronic respiratory symptoms; (2) onset of symptoms after a single exposure incident; (3) exposure to a very corrosive agent; (4) onset of symptoms within 24 hours of the exposure with persistence for 3 months; (5) persistence of asthmalike symptoms; (6) presence of airflow obstruction, as determined on the basis of spirometric results, the presence of nonspecific BHR, or both; and (7) exclusion of all other pulmonary disorders. 23 There are only limited pathologic studies related to RADS. They have demonstrated a predominance of lymphocytes in bronchial washings, with evidence of subepithelial thickening and fibrosis.…”

Section: Pathogenesis Of Oamentioning

confidence: 99%

“…The process is postulated to be the result of extensive denudation of bronchial epithelium, resulting in inflammation and release of proinflammatory chemotactic and toxic mediators. 23 …”

Section: Pathogenesis Of Oamentioning

confidence: 99%

See 2 more Smart Citations

10. Occupational asthma

Bardana

2008

Journal of Allergy and Clinical Immunology

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Section: Pathogenesis Of Oamentioning

confidence: 99%

Section: Pathogenesis Of Oamentioning

confidence: 99%

See 1 more Smart Citation

10. Occupational asthma

Bardana

2008

Journal of Allergy and Clinical Immunology

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“…Four years later, Brooks and colleagues (1985) described the clinical and pathological features of RADS. The sudden onset of asthmalike symptoms and persistence of airway reactivity following a high-level acute respiratory exposure to an irritant gas has been termed reactive airways dysfunction syndrome (RADS) (Alberts & doPico, 1996;Bardana, 1999) or "irritant-induced asthma" (Brooks et al, 1998). Since 1985, RADS has been reported as originating from many different substances (Brooks & Lockey, 1981).…”

mentioning

confidence: 99%

Reactive Airways Dysfunction Syndrome in Housewives Due to a Bleach–Hydrochloric Acid Mixture

Görgüner

Aslan

İnandı

et al. 2004

Inhalation Toxicology

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The sudden onset of asthmalike symptoms and persistence of airway reactivity following an acute exposure to an irritant gas or vapor has been termed reactive airways dysfunction syndrome (RADS). A mixture of sodium hypochlorite (bleach, 40%) and hydrochloric acid (18%) is commonly used as a household cleaning solution in our region. From this mixture, chlorine gas is produced, which can cause airway damage and ensuing RADS. Here we describe findings of patients with RADS due to this cleaning mixture, and determine factors associated with a favorable outcome. Data were collected retrospectively on 55 symptomatic patients presenting to our emergency department after inhalation exposure to a mixture of bleach and hydrochloric acid. Symptoms, past medical and smoking history, details of the exposure, initial peak expiratory flow rate (PEFR) and oxygenation, and acute reversibility of airways obstruction were documented. All patients met previously defined criteria for the diagnosis of RADS, but did not undergo methacholine challenge testing and bronchoalveolar lavage or histopathologic study. Fifty patients were followed over the course of 3 mo. The majority of exposures (64%) occurred in the bathroom or kitchen. Only 21 of 55 (38%) patients showed an improvement in PEFR of 15% or greater following two beta(2)-agonist inhalation treatments. In follow-up, 48 patients (87%) improved clinically and functionally (FEV(1)). Seven patients (13%) deteriorated, with ARDS developing in two, one of whom died from respiratory failure. Advanced age, initial low PEFR, exposure in a small enclosed area, use immediately after mixing, and prolonged short- and long-term exposures were associated with a poorer prognosis. This descriptive study is the largest case series in the literature of RADS developing after exposure to a bleach-hydrochloric acid mixture. The optimum acute treatment and long-term outcomes for patients with RADS due to this combination still need to be determined.

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“…RADS is related to an acute, one-time high exposure to a respiratory irritant such as irritant gases, fumes, or chemicals whereas low dose RADS is related to repeated low-dose exposure to respiratory irritants. 30,31,32,33,34 Asthma that may be attributable to irritant exposures has received less study than allergy-induced asthma, and its prevalence is unknown.…”

Section: Occupational Asthmamentioning

confidence: 99%

Health hazard evaluation report: HETA-96-0253-2682, General Dynamics, Electric Boat Division, Groton, Connecticut.

1998

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Reactive Airways Dysfunction Syndrome

Cited by 111 publications

References 39 publications

10. Occupational asthma

10. Occupational asthma

Reactive Airways Dysfunction Syndrome in Housewives Due to a Bleach–Hydrochloric Acid Mixture

Health hazard evaluation report: HETA-96-0253-2682, General Dynamics, Electric Boat Division, Groton, Connecticut.

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