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Journal of Occupational Medicine and Toxicology

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Open Access 01-12-2014 | Research

Diisocyanate-induced asthma in Switzerland: long-term course and patients’ self-assessment after a 12-year follow-up

Authors: Martin Rüegger, Doreen Droste, Markus Hofmann, Marcel Jost, David Miedinger

Published in: Journal of Occupational Medicine and Toxicology | Issue 1/2014

Abstract

Background

Isocyanates are among the most common causes of occupational asthma (OA) in Switzerland. Patients with OA have been shown to have unfavourable medical, socioeconomic and psychological outcomes. We investigated long-term asthma and the socio-economic outcomes of diisocyanate-induced asthma (DIA) in Switzerland.

Patients and methods

We conducted an observational study on 49 patients with DIA and followed 35 of these patients over a mean exposure-free interval of 12 ± 0.5 (range 11.0-13.0) years. At the initial and follow-up examinations, we recorded data on respiratory symptoms and asthma medication; measured the lung function; and tested for bronchial hyperreactivity. We allowed the patients to assess their state of health and overall satisfaction using a visual analogue scale (VAS) at these visits.

Results

The 35 patients whom we could follow had a median symptomatic exposure time of 12 months, interquartile range (IQR) 26 months and a median overall exposure time of 51 (IQR 104) months. Their subjective symptoms (p < 0.001) and the use of asthma medication (p = 0.002), particularly the use of inhaled corticosteroids (p < 0.001), decreased by nearly 50%. At the same time, the self-assessment of the patients’ state of health and overall satisfaction increased considerably according to both symptomatology and income. In contrast, slight reductions in terms of FVC% predicted from 102% to 96% (p = 0.04), of FEV1% predicted from 91% to 87% (p = 0.06) and of the FEV1/FVC ratio of 3%; (p = 0.01) were observed while NSBHR positivity did not change significantly. In univariate as well as multivariate logistic analyses we showed significant associations between age, duration of exposure and FEV1/FVC ratio with persistent asthma symptoms and NSBHR.

Conclusions

We found that the patients’ symptoms, the extent of their therapy and the decrease in their lung volumes during the follow-up period were similar to the findings in the literature. The same hold true for some prognostic factors, whereas the patients’ self-assessment of their state of health and overall satisfaction improved considerably.

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Title: Diisocyanate-induced asthma in Switzerland: long-term course and patients’ self-assessment after a 12-year follow-up
Authors: Martin Rüegger
Doreen Droste
Markus Hofmann
Marcel Jost
David Miedinger
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Journal of Occupational Medicine and Toxicology / Issue 1/2014
Electronic ISSN: 1745-6673
DOI: https://doi.org/10.1186/1745-6673-9-21

At a glance: The STEP trials

Springer Medicine

Diisocyanate-induced asthma in Switzerland: long-term course and patients’ self-assessment after a 12-year follow-up

Abstract

Background

Patients and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusions

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