Long-term outcomes of acute irritant-induced asthma

Am J Respir Crit Care Med. 2009 May 15;179(10):923-8. doi: 10.1164/rccm.200810-1550OC. Epub 2009 Feb 20.


Rationale: The long-term outcomes of acute irritant-induced asthma (IIA) are mostly unknown.

Objectives: To study the long-term outcomes of IIA.

Methods: We reassessed 35 subjects who experienced IIA at a mean interval of 13.6 +/- 5.2 years.

Measurements and main results: The causal agent was chlorine in 20 cases (57%). At diagnosis, the mean +/- SD FEV(1) was 74.5 +/- 19.5% predicted, and all subjects showed bronchial hyperresponsiveness. At reassessment, all subjects reported respiratory symptoms, and 24 (68%) were on inhaled steroids. There were no significant improvements in FEV(1) and FEV(1)/FVC values. Twenty-three subjects had a methacholine test, and only six subjects had normal levels of responsiveness. Of the remaining 12 subjects, six had improvement in FEV(1) after bronchodilator >or=10%. In samples of induced sputum obtained from 27 subjects, six had eosinophils >or=2%. Levels of inflammatory and remodeling mediators were higher than in control subjects but were no different from subjects with occupational asthma due to sensitization. Quality of life score was 4.4 +/- 1.5 on a 0 (worst) to 7 (best) scale. Twelve subjects had an abnormal depression score.

Conclusions: This study provides the first evidence of significant long-term impact of acute IIA on various outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidents, Occupational
  • Adult
  • Asthma / chemically induced*
  • Asthma / physiopathology
  • Asthma / psychology
  • Bronchial Hyperreactivity / chemically induced
  • Bronchial Hyperreactivity / physiopathology
  • Bronchial Hyperreactivity / psychology
  • Chlorine / poisoning*
  • Female
  • Follow-Up Studies
  • Humans
  • Inhalation Exposure / adverse effects
  • Irritants / poisoning*
  • Male
  • Middle Aged
  • Occupational Diseases / chemically induced*
  • Occupational Diseases / physiopathology
  • Occupational Diseases / psychology
  • Occupational Exposure / adverse effects
  • Sputum / chemistry
  • Sputum / cytology
  • Treatment Outcome


  • Irritants
  • Chlorine