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Occupational and Environmental Lung Disease |

Outcome of Occupational Asthma in Patients With Continuous Exposure*: A 3-Year Longitudinal Study During Pharmacologic Treatment

Alessandra Marabini; Andrea Siracusa; Roberta Stopponi; Cinzia Tacconi; Giuseppe Abbritti
Author and Funding Information

*From the Occupational Medicine and Toxicology Section (Drs. Marabini, Stopponi, and Abbritti) and Occupational and Environmental Allergology (Drs. Siracusa and Tacconi), Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.

Correspondence to: Alessandra Marabini, MD, Medicina del Lavoro e Tossicologia, Via E. Dal Pozzo, 06126 Perugia, Italy; e-mail: modall@unipg.it



Chest. 2003;124(6):2372-2376. doi:10.1378/chest.124.6.2372
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Study objective: To evaluate the effect of treatment with beclomethasone dipropionate (500 μg bid) and salmeterol (50 μg bid) on lung function and respiratory symptoms in 20 subjects with occupational asthma (OA) still exposed to the work environment cause of their disease.

Methods: At enrollment and every 6 months for 3 years, respiratory symptom score (from 0 [no symptoms] to 2 [moderate-to-severe symptoms]), spirometry, methacholine challenge, peak expiratory flow (PEF) variability, and the use of rescue salbutamol were evaluated. During the 3 years of follow-up, 10 subjects were excluded from the study because they retired or changed jobs.

Measurements and results: Symptoms of work-related asthma started 12.6 ± 13.1 years (mean ± SD) before diagnosis. At baseline, mean FEV1 was 80.2% of predicted values and provocative dose of methacholine causing a 20% fall in FEV1 (PD20) was 1,001 ± 1,275 μg; the workers received 2.1 ± 2.4 puffs of salbutamol per day. After 3 years, no significant differences in any of the morbidity outcomes (FEV1, PD20, PEF variability, use of rescue salbutamol, respiratory symptom score) were found as compared with baseline or run-in values.

Conclusions: Regular treatment with inhaled corticosteroids and long-acting bronchodilators seems to prevent respiratory deterioration over a 3-year period in workers with mild-to-moderate persistent OA who were still exposed at work to the environmental cause of their disease.


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