New methodology for specific inhalation challenges with occupational agents

详细信息    查看全文

• 作者：Simon Caron (1)
  Jean-Christian Boileau (1)
  Jean-Luc Malo (2)
  Simon Leblond (1)
  
• 刊名：Respiratory Research
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：11
• 期：1
• 全文大小：1024KB
• 参考文献：1. Vandenplas O, Toren K, Blanc P: Health and socioeconomic impact of work-related asthma. / Eur Respir J 2003, 22:689鈥?97. CrossRef
  2. Chan-Yeung M, Malo JL: Occupational asthma. / N Engl J Med 1995, 333:107鈥?12. CrossRef
  3. Bernstein DI, Campo P, Baur X: Clinical Assessment and Management of Occupational Asthma. In / Asthma in the workplace. 3rd edition. Edited by: Bernstein IL, Chan-Yeung M, Malo JL, Bernstein DI. Taylor & Francis., New York; 2006:pp161鈥?78.
  4. Rioux JP, Malo JL, L'Archev锚que J, Rabhi K, Labrecque M: Workplace specific challenges as a contribution to the diagnosis of occupational asthma. / Eur Respir J 2008, 32:997鈥?003. CrossRef
  5. Pepys J, Hutchcroft BJ: Bronchial provocation tests in etiologic diagnosis and analysis of asthma. / Am Rev Respir Dis 1975, 112:829鈥?9.
  6. Cloutier Y, Lagier F, Lemieux R, Blais MC, St-Arnaud C, Cartier A, Malo JL: New methodology for specific inhalation challenges with occupational agents in powder form. / Eur Respir J 1989, 2:769鈥?7.
  7. Vandenplas O, Malo JL, Cartier A, Perreault G, Cloutier Y: Closed-circuit methodology for inhalation challenge test with isocyanates. / Am Rev Respir Dis 1992, 145:582鈥?7.
  8. Cartier A, Malo JL, Dolovich J: Occupational asthma in nurses handling psyllium. / Clin Allergy 1987, 17:1鈥?. CrossRef
  9. Malo JL, Cartier A, Lemi猫re C, Desjardins A, Labrecque M, L'Archev锚que J, Perrault G, Lesage J, Cloutier Y: Exaggerated bronchoconstriction due to inhalation challenges with occupational agents. / Eur Respir J 2004, 23:300鈥?03. CrossRef
  10. American Thoracic Society: Standardization of spirometry. / Am J Respir Crit Care Med 1995, 152:1107鈥?136.
  11. American Thoracic Society: Guidelines for methacholine and exercise challenge testing. / Am J Respir Crit Care Med 1999, 161:309鈥?29.
  12. Pizzichini E, Pizzichini MMM, Efthimiadis A, Evans S, Morris MM, Squillace D, Gleich GJ, Dolovich J, Hargreave FE: Indices of airway inflammation in induced sputum: reproducibility and validity of cell and fluid-phase measurements. / Am J Respir Crit Care Med 1996, 154:308鈥?17.
  13. Vandenplas O, Cartier A, Malo JL: / Occupational Challenge Tests. Edited by: Bernstein IL, Chan-Yeung M, Malo JL, Bernstein DI. Taylor & Francis, New York; 2006:227鈥?52.
  14. Choudat D, Fabri猫s JF, Martin JC, Villette C, Tabka F, Dessanges JF, Dall Ava J, Conso F: Quantification of the dose of inhaled flour: relation with nonspecific bronchial and immunological reactivities. / Eur Respir J 1999, 14:328鈥?34. CrossRef
  
• 作者单位：Simon Caron (1)
  Jean-Christian Boileau (1)
  Jean-Luc Malo (2)
  Simon Leblond (1)
  
  1. SCL Medtech Inc., Montreal, Canada
  2. Department of Chest Medicine, Sacr茅-C艙ur Hospital, Montreal, Canada
  

文摘

Background Inhalation challenges are used for diagnosing occupational asthma (OA). The initial methodology consisted of a "realistic" exposure without monitoring nor controlling exposure. Our aim was to design an equipment, called the GenaSIC, that allows the generation of various agents regardless of the formulation and to assess the feasibility of its use in patients investigated for OA. Results GenaSIC can generate lactose, flour, malt, isocyanates, formaldehyde and N-butyl acetate with precise and fairly stable concentrations. Using N-butyl-acetate as a control agent and real time measurement, we show that normal breathing has a negligible effect on the concentration. We exposed forty-four different subjects to a control agent and/or to a suspected occupational agent. Nineteen of the subjects were only exposed to N-butyl acetate as a control agent without experiencing any significant irritant effect (no significant changes in spirometry thereafter). Eight subjects who were exposed to both N-butyl acetate and formaldehyde did not show significant reactions. Seven subjects were exposed to dry particles (flour in six instances, malt in the other) and five showed immediate asthmatic reactions which changes in FEV1 from 20% to a maximum of 28%. Finally, ten subjects were exposed to isocyanates, four of whom showed a positive reaction, including one subject with immediate maximum changes in FEV1 of 22%. Conclusion GenaSIC offers the possibility of reliable and safe exposures to dry particles, formaldehyde and isocyanates in the investigation of OA.