Background: Previous studies reported that early diagnosis and avoidance therapy are the most important factors for prevention of permanent lung impairment; however, few studies have evaluated the long-term prognosis of reactive dye-induced occupational asthma (RD-OA). Objective: To evaluate the long-term outcomes of RD-OA. Methods: Methacholine airway hyperresponsiveness (AHR) and lung functions were evaluated and compared in 26 patients with RD-OA at the time of diagnosis and after complete avoidance of the causative agents. Patients with continued (n = 13) or remitted (n = 6) AHR were further monitored for up to a mean ± SD of 8.7 ± 1.8 years. Results: The AHR resolved in 10 (38%) of 26 patients a mean ± SD of 2.2 ± 1.3 years after complete avoidance of RDs; however, prebronchodilator forced expiratory volume in 1 second (FEV1) values were not different. Levels of IgE specific to the RD-human serum albumin complex were markedly decreased at first follow-up in 5 RD-atopic patients from whom paired serum samples were compared (P = .02). The AHR disappeared in an additional 5 patients and improved in 4 by the second follow-up. The FEV1 values also improved compared with diagnosis and first follow-up levels. Favorable prognosis was associated with early diagnosis of RD-OA and complete avoidance of the causative agent. No association was found with smoking history, latent periods, the presence of RD specific IgE, baseline provocation concentration that caused a decrease in FEV1 of 20%, or FEV1. Conclusions: Early diagnosis and avoidance therapy are the most important prognostic factors in RD-OA. The AHR and lung function of patients with RD-OA can sometimes be recovered steadily and slowly through avoidance measures.
Bibliographical noteFunding Information:
* Institute of Allergy, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. † Korean Industrial Health Research Institute, Seoul, Korea. This work was supported by Clinical Research Center for Chronic Obstructive Airway Disease grant 0412-CR03-0704-0001 from the Korean Ministry of Health and Welfare. Received for publication February 23, 2006. Accepted for publication in revised form June 7, 2006.
All Science Journal Classification (ASJC) codes
- Immunology and Allergy
- Pulmonary and Respiratory Medicine