Objectives The aim of this study was to assess the predictors of a favourable prognosis of occupational asthma (OA) and the employment status of patients with OA at least 2 years after diagnosis.
Methods We collected data from 204 patients who had a diagnosis of OA confirmed by a positive specific inhalation challenge. We defined OA remission as meeting the following three criteria: no asthma symptoms, no antiasthma therapy for the last year and having normal lung function at the end of follow-up. A logistic regression analysis was performed to estimate the effects of the covariates.
Results At 10.6±7.8-year follow-up, 60 of 204 possible patients participated in the study, and among them 17 showed OA remission. When compared with the 43 patients with persistent OA, these patients exhibited at diagnosis younger age (p=0.0039), shorter duration of symptomatic exposure (p=0.0512), better lung function expressed by higher forced vital capacity (FVC%) predicted (p=0.0164), forced expiratory volume in 1 s (FEV1) % predicted (p=0.0066) and FEV1/FVC% (p=0.0132), and less bronchial hyper-responsiveness (p=0.0118). Nevertheless, in the multivariable model, no variables were significantly associated with OA remission. At follow-up, three individuals have retired; among the remaining 57 workers, 91.2% were still employed and 43.8% of them had continued working in the same factory after ceasing exposure to the causative agent.
Conclusions This monocentric study did not identify a strong predictor of OA remission, but documented a high employment rate and a good job preservation over a long timeframe after diagnosis of OA mainly induced by low molecular weight agents.
- Allergy and Immunology
- Respiratory System
- Occupational Health
Data availability statement
All data relevant to the study are included in the article.
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Contributors PMas contributed to study conception and design, analysis and interpretation of data, drafting the manuscript for important intellectual content, reading and approval of the final manuscript and acted as guarantor. FL, ERP and MB contributed to data collection, drafting the manuscript for important intellectual content, and reading and approval of the final manuscript. PMae contributed to study conception, design and interpretation of data, and drafting the manuscript for important intellectual content. ACF contributed to statistical analysis of the results, drafting the manuscript for important intellectual content, and reading and approval of the final manuscript.
Funding This work was supported by Grant BIRD199479 from the Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.