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Mild Improvement in Symptoms and Pulmonary Function in a Long-Term Follow-Up of Patients with Toluene Diisocyanate-Induced Asthma.
MedLine Citation:
PMID:  23343863     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Long-term follow-up of diisocyanate-induced occupational asthma has been occasionally reported. Methods: We studied the outcome of toluene diisocyanate (TDI)-induced asthma in 46 patients at diagnosis and after a follow-up of 11 ± 3.6 years. Symptoms, anti-asthma therapy, forced expiratory volume in 1 s (FEV(1)) and bronchial hyperresponsiveness to methacholine were assessed. Results: A significant improvement in FEV(1) (% predicted) and PD20FEV(1) methacholine was observed at follow-up in comparison with diagnosis. Anti-asthma treatment was performed by 42% of patients at diagnosis and by 70% at follow-up. At the time of follow-up, 32 subjects had been removed from exposure for 6.0 ± 6.9 years, whereas 14 subjects continued to work with reduced exposure to TDI. There was a significant reduction in the prevalence of attacks of shortness of breath and dyspnoea at follow-up, but only in unexposed patients. PD20FEV(1) was significantly improved only in patients with a lower FEV(1) at diagnosis and in those who have ceased work. Logistic regression analysis, using different models with some independent variables, showed that there were no significant determinants of improvement in FEV(1) at follow-up, while a shorter duration of symptoms before diagnosis was a significant predictor of improvement in PD20FEV(1) at follow-up. Conclusions: Asthma-like symptoms, bronchial hyperresponsiveness and airway obstruction improved, but did not normalize, after a long-term follow-up with cessation or reduction in TDI exposure, mainly in subjects with an early diagnosis of occupational asthma and in patients with a lower baseline FEV(1) no longer exposed to TDI.
Authors:
D Talini; F Novelli; E Bacci; F Costa; F L Dente; A Di Franco; L Malagrinò; B Vagaggini; P Paggiaro
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-23
Journal Detail:
Title:  International archives of allergy and immunology     Volume:  161     ISSN:  1423-0097     ISO Abbreviation:  Int. Arch. Allergy Immunol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9211652     Medline TA:  Int Arch Allergy Immunol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  189-194     Citation Subset:  -    
Copyright Information:
Copyright © 2013 S. Karger AG, Basel.
Affiliation:
Cardiothoracic and Vascular Department, University of Pisa, Pisa, Italy.
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