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Vol. 44. Issue 3.
Pages 140-145 (January 2008)
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Vol. 44. Issue 3.
Pages 140-145 (January 2008)
Original Articles
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Course of Bronchial Hyperresponsiveness in Patients With Occupational Asthma Caused by Exposure to Persulfate Salts
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4419
Xavier Muñoza,b,c,
Corresponding author
xmunoz@vhebron.net

Correspondence: Dr X. Muñoz Servei de Pneumologia, Hospital General Vall d'Hebron Pg. Vall d'Hebron, 11908035 Barcelona, Spain
, Susana Gómez-Ollésa,b, María Jesús Cruza,b, María Dolores Untoriaa,b, Ramon Orriolsa,b, Ferran Morella,b
a Servei de Pneumologia, Hospital Vall d'Hebron, Barcelona, Spain
b CIBER Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
c Departament de Biologia Cel·lular, Fisiologia, Immunologia, Universitat Autònoma de Barcelona, Barcelona, Spain
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Objective

Persulfate salts are among the most frequently implicated causes of occupational asthma. The aim of this study was to describe the course of bronchial hyperresponsiveness and immunologic test results in patients with occupational asthma due to persulfate salts.

Patients and methods

Ten patients with occupational asthma due to persulfate salts were studied. Diagnosis was based on specific bronchial challenge tests performed at least 3 years before enrollment. An exhaustive medical and work history was taken during interviews with all patients, and all underwent spirometry and nonspecific bronchial challenge testing. Total immunoglobulin E levels were determined and skin prick tests to several persulfate salts were performed.

Results

At the time of evaluation, 7 patients had avoided workplace exposure to persulfate salts. The bronchial hyperresponsiveness of 3 of those 7 patients had improved significantly. No improvement was observed in patients who continued to be exposed. Specific skin prick tests became negative in 3 patients who were no longer exposed at the time of the follow-up evaluation. Most of the patients continued to report symptoms, although improvements were noted. One patient, however, reported worsening of symptoms in spite of avoidance of exposure.

Conclusions

Although asthma symptoms and bronchial hyperresponsiveness may persist for patients with occupational asthma due to persulfate salts, their condition seems to improve if they avoid exposure. This course does not seem to differ from that reported for other cases of occupational asthma.

Key words:
Methacholine
Skin prick test
Follow-up monitoring
Rhinitis
Hairdressers
Objetivo

Las sales de persulfato son uno de los agentes más frecuentemente implicados en el origen del asma ocupacional (AO). El objetivo de este estudio ha sido establecer la evolución de la hiperrespuesta bronquial y de las pruebas inmunológicas en pacientes con AO por persulfatos en función de que persista o no la exposición a dichas sales.

Pacientes y métodos

Se estudió a 10 pacientes con AO por exposición a sales de persulfato, diagnosticados con prueba de provocación bronquial específica, en los que como mínimo habían transcurrido 3 años tras el diagnóstico. En todos los casos se realizaron un exhaustivo interrogatorio clínico y laboral, espirometría forzada y prueba de provocación bronquial inespecífica con metacolina, se determinaron los valores de inmunoglobulina E total y se practicaron pruebas cutáneas con las distintas sales de persulfato.

Resultados

En el momento del control evolutivo, 7 pacientes habían abandonado la exposición a persulfatos. De los pacientes con hiperrespuesta bronquial positiva que habían abandonado el trabajo, se observó una mejoría significativa de ésta en 3 de ellos. Este hecho no se observó en ninguno de los pacientes que siguieron expuestos. La prueba cutánea específica se negativizó en 3 pacientes que no estaban expuestos en el momento del control evolutivo. Desde el punto de vista clínico, la mayoría de los pacientes continuaron presentando síntomas, aunque éstos habían mejorado, excepto en un caso en que, a pesar de evitar la exposición, empeoraron.

Conclusiones

Aunque pueden persistir los síntomas de asma y la hiperrespuesta bronquial positiva, la evolución de los pacientes con AO por persulfato parece ser favorable si se evita la exposición. Esta respuesta no parece diferir de la comunicada en otros casos de AO.

Palabras clave:
Metacolina
Prueba cutánea
Seguimiento
Rinitis
Profesionales de peluquería
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References
[1]
JC McDonald, Y Chen, C Zekveld, NM Cherry.
Incidence by occupation and industry of acute work related respiratory diseases in the UK, 1992–2001.
Occup Environ Med, 62 (2005), pp. 836-842
[2]
S Provencher, FP Labrece, L de Guire.
Physician based surveillance system for occupational respiratory diseases: the experience of PROPULSE, Quebec, Canada.
Occup Environ Med, 41 (1997), pp. 272-276
[3]
H Keskinen, K Alanko, L Saarinen.
Occupational asthma in, Finland.
Clin Allergy, 8 (1978), pp. 569-579
[4]
J Ameille, G Pauli, A Calastreng-Crinquand, D Vervloët, Y Iwatsubo, E Popin, the corresponding members of the ONAP, et al.
Reported incidence of occupational asthma in France, 1996–99: the ONAP programme.
Occup Environ Med, 60 (2003), pp. 136-141
[5]
R Orriols, R Costa, M Albanell, C Alberti, J Castejón, E Monsó, et al.
members of the Malaltia Ocupacional Respiratòria (MOR) Group. Reported occupational respiratory diseases in Catalonia.
Occup Environ Med, 63 (2006), pp. 255-260
[6]
MC Kopferschmitt-Kubler, J Ameille, E Popin, A Calastreng-Crinquand, D Vervloet, MC Bayeux-Dunglas, Observatoire National de Asthmes Professionnels Groupe, et al.
Occupational asthma in France: a 1-yr reported of the Observatoire National de Asthmes Professionnels project.
Eur Respir J, 19 (2002), pp. 84-89
[7]
AD Blainey, S Ollier, D Cundell, RE Smith, RJ Davies.
Occupational asthma in a hairdressing salon.
Thorax, 41 (1986), pp. 42-50
[8]
P Macchioni, C Kotopoulus, D Talini, M De Santis, E Masino, PL Paggiaro.
Asthma in hairdressers: a report of 5 cases.
Med Lav, 90 (1999), pp. 776-785
[9]
X Muñoz, MJ Cruz, R Orriols, C Bravo, M Espuga, F Morell.
Occupational asthma due to persulfate salts. Diagnosis and followup.
Chest, 123 (2003), pp. 2124-2129
[10]
G Moscato, P Pignatti, MR Yacoub, C Romano, S Spezia, L Perfetti.
Occupational asthma and occupational rhinitis in hairdressers.
Chest, 128 (2005), pp. 3590-3598
[11]
PJ Nicholson, P Cullinan, AJ Taylor, PS Burge, C Boyle.
Evidence based guidelines for the prevention, identification, and management of occupational asthma.
Occup Environ Med, 62 (2005), pp. 290-299
[12]
G Rachiotis, R Savani, A Brant, SJ MacNeill, A Newman Taylor, P Cullinan.
The outcome of occupational asthma after cessation of exposure: a systematic review.
Thorax, 62 (2007), pp. 147-152
[13]
X Muñoz, MJ Cruz, R Orriols, F Torres, M Espuga, F Morell.
Validation of specific inhalation challenge for the diagnosis of occupational asthma due to persulfate salts.
Occup Environ Med, 61 (2004), pp. 861-866
[14]
TEJ Renkema, JP Schouten, GH Keter, DS Postma.
Effects of long term treatment with corticosteroids in COPD.
Chest, 109 (1996), pp. 1156-1162
[15]
Global Strategy for Asthma Management and Prevention. NHL-BI/WHO Workshop report. NHI publication 1995, N 02-3659. Update of Executive Committee Report in 2002. p.136. Available from: www.ginasthma.com
[16]
J Sanchís Aldás, P Casan Clará, J Castillo Gómez, N Gómez Mangado, L Palenciano Ballesteros, J Roca Torrent.
Normativa para la espirometría forzada. Recomendaciones SEPAR núm. 1. Barcelona: Ediciones Doyma SA; 1985.
Arch Bronconeumol, 25 (1989), pp. 132-142
[17]
J Roca, J Sanchís, A Agustí-Vidal, F Segarra, D Navajas, R Rodríguez-Roisin, et al.
Spirometric reference values from a Mediterranean population.
Bull Eur Physiopathol Respir, 22 (1986), pp. 217-224
[18]
H Chai, R Farr, LA Froehlich, DA Mathison, JA McLean, RR Rosenthal, et al.
Standardization of bronchial inhalation challenge procedures.
J Allergy Clin Immunol, 56 (1975), pp. 323-327
[19]
PJ Sterk, LM Fabbri, PhH Quanjer, DW Cockcroft, PM O'Byrne, SD Anderson, et al.
Airways responsiveness. Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults.
Eur Respir J, 6 (1993), pp. 53-83
[20]
L Perfetti, A Cartier, H Ghezzo, D Gautrin, JL Malo.
Follow-up of occupational asthma after removal from or diminution of exposure to the responsible agent.
Chest, 114 (1998), pp. 398-403
[21]
J Pepys.
Skin test in diagnosis.
Clinical aspects of immunology, 3rd ed., pp. 55-80
[22]
F Morell, R Codina, MJ Rodrigo.
Increased positivity of skin test and allergenic stability of glycerinated soybean hull extracts.
Clin Exp Allergy, 29 (1999), pp. 388-393
[23]
X Muñoz, MJ Cruz, R Orriols, C Bravo, M Espuga, F Morell.
Occupational asthma due to persulfate salts.
Chest, 123 (2003), pp. 2122-2127
[24]
M Chan-Yeung, L Maclean, PL Paggiaro.
Follow-up study of 232 patients with occupational asthma caused by Western red cedar (Thuja plicata).
J Allergy Clin Immunol, 79 (1987), pp. 792-796
[25]
PL Paggiaro, B Vagaggani, E Bacci, L Bancalari.
Prognosis of occupational asthma.
Eur Respir J, 7 (1994), pp. 761-767
[26]
PL Paggiaro, AM Loi, O Rossi, B Ferrante, F Pardi, MG Roselli, et al.
Follow up study of patients with respiratory disease due to TDI.
Clin Allergy, 14 (1984), pp. 463-469
[27]
M Chan-Yeung, S Lam, S Koener.
Clinical features and natural history of occupational asthma due to red cedar (Thuja plicata)..
Am J Med, 72 (1982), pp. 411-415
[28]
N Rosenberg, R Garnier, X Rousselin, R Mertz, P Gervais.
Clinical and socio-professional fate of isocyanate-induced asthma.
Clin Allergy, 17 (1987), pp. 55-61
[29]
J Côté, S Kennedy, M Chan-Yeung.
Outcome of patients with red cedar asthma with continuous exposure.
Am Rev Respir Dis, 141 (1990), pp. 373-376
[30]
G Moscato, A Dellabianca, L Perfetti, B Bramè, E Galdi, R Niniano, et al.
Occupational asthma. A longitudinal study on the clinical and socioeconomic outcome after diagnosis.
Chest, 115 (1999), pp. 249-256
[31]
R Orriols, ME Drobnic, X Muñoz, MJ Rodrigo, F Morell.
Asma ocupacional por isocianatos: estudio de 21 pacientes.
Med Clin (Barc), 113 (1999), pp. 659-662
[32]
JL Malo, H Ghezzo.
Recovery of methacholine responsiveness after end of exposure in occupational asthma.
Am J Respir Crit Care Med, 169 (2004), pp. 1304-1307
[33]
M Padoan, V Pozzato, M Simoni, L Zedda, G Milan, J Bononi, et al.
Long-term follow-up of toluene diisocyanate-induced asthma.
Eur Respir J, 21 (2003), pp. 637-640
[34]
C Allard, A Cartier, H Ghezzo, JL Malo.
Occupational asthma due to various agents. Absence of clinical and functional improvement at an interval of four or more years after cessation of exposure.
Chest, 96 (1989), pp. 1046-1049
[35]
R Merget, M Reineke, A Rueckmann, EM Bergmann, G Schultze-Werninghaus.
Nonspecific and specific bronchial responsiveness in occupational asthma caused by platinum salts after allergen avoidance.
Am J Respir Crit Care Med, 150 (1994), pp. 1146-1149
[36]
L Perfetti, A Cartier, H Ghezzo, D Gautrin, JL Malo.
Follow-up of occupational asthma after removal from or diminution of exposure to the responsible agent: relevance of the length of the interval from cessation of exposure.
Chest, 114 (1998), pp. 398-403
[37]
K Maghni, C Lemière, H Ghezzo, W Yuquan, JL Malo.
Airway inflammation after cessation of exposure to agents causing occupational asthma.
Am J Respir Crit Care Med, 169 (2004), pp. 367-372
[38]
O Vandenplas, J Jamart, JP Delwiche, G Evrard, A Larbanois.
Occupational asthma caused by natural rubber latex: outcome according to cessation or reduction of exposure.
J Allergy Clin Immunol, 109 (2002), pp. 125-130
[39]
HW Park, DI Kim, SW Sohn, CH Park, SS Kim, YS Chang, et al.
Outcomes in occupational asthma caused by reactive dye after long-term avoidance.
Clin Exp Allergy, 37 (2007), pp. 225-230
[40]
JL Malo, A Cartier, H Ghezzo, M la France, M McCants, SB Lehrer.
Patterns of improvement in spirometry, bronchial hyperresponsiveness, and specific IgE antibody levels after cessation of exposure in occupational asthma caused by snow crab processing.
Am Rev Respir Dis, 138 (1988), pp. 807-812
[41]
RD Barker, JM Harris, JA Welch, KM Venables, AJ Newman Taylor.
Occupational asthma caused by tetrachlorophthalic anhydride: a 12-year follow-up.
J Allergy Clin Immunol, 101 (1998), pp. 717-719
[42]
DE Bice, SE Jones, BA Muggenburg.
Long-term antibody production after lung immunization and challenge: role of lung and lymphoid tissues.
Am J Respir Cell Mol Biol, 6 (1993), pp. 662-667

This study was partly funded by grant number FIS PI050100 from the Carlos III Institute of Health.

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