Irritant-induced asthma

Curr Opin Allergy Clin Immunol. 2012 Apr;12(2):140-4. doi: 10.1097/ACI.0b013e32835143b8.


Purpose of review: To describe the recent insights into the definition, causes, natural outcome, and key elements of irritant-induced asthma (IIA) management.

Recent findings: IIA is a subtype of occupational asthma without immunologic sensitization and includes the typical reactive airway dysfunction syndrome (RADS) and a more gradual form called not-so-sudden IIA, when onset of asthma follows repeated low-dose exposure to irritants. The World Trade Center tragedy brought new insight in the understanding of IIA, suggesting that it can exhibit a prolonged interval between exposure and recognition of clinical symptoms and disease. Dimethyl sulfate has been recently reported to cause RADS and repeated diesel exhaust exposure to cause not-so-sudden IIA in patients who worked in a bus garage. Cleaning workers who are exposed to a large variety of irritants and sensitizers are especially at risk of occupational asthma and IIA.

Summary: IIA includes RADS and not-so-sudden IIA. Outcome of IIA is as poor as occupational asthma with sensitization. Treatment of IIA does not differ from standard asthma treatment, but high-dose vitamin D could be assessed further for possible therapeutic benefit.

Publication types

  • Review

MeSH terms

  • Anti-Asthmatic Agents / therapeutic use
  • Asthma, Occupational / chemically induced*
  • Asthma, Occupational / drug therapy
  • Detergents / adverse effects
  • Humans
  • Irritants / adverse effects
  • Occupational Exposure
  • September 11 Terrorist Attacks
  • Sulfuric Acid Esters / adverse effects
  • Treatment Outcome
  • Vehicle Emissions / toxicity
  • Vitamin D / therapeutic use


  • Anti-Asthmatic Agents
  • Detergents
  • Irritants
  • Sulfuric Acid Esters
  • Vehicle Emissions
  • Vitamin D
  • dimethyl sulfate