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Factors associated with severity of occupational asthma with a latency period at diagnosis

Authors

  • A. Descatha,

    1. AP-HP, Hôpital R. Poincaré, Unité de pathologie professionnelle, Garches, France
    2. INSERM, U687, F-94410, France; Université Paris XI, IFR69, Villejuif, F-94807, Saint-Maurice, France; Université Versailles-Saint Quentin, Faculté de Médecine Paris-Ile-de-France-Ouest, Paris, France
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  • H. Leproust,

    1. AP-HP, Hôpital R. Poincaré, Unité de pathologie professionnelle, Garches, France
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  • D. Choudat,

    1. Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Paris, F-75005, France
    2. AP-HP, Service de pathologie professionnelle, Faculté de médecine Paris 5, F-75014, France
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  • R. Garnier,

    1. Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Paris, F-75005, France
    2. AP-HP, Consultation de pathologie professionnelle, Hôpital F. Widal, Paris, F-75010, France
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  • J.-C. Pairon,

    1. Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Paris, F-75005, France
    2. Unité de pathologie professionnelle, Créteil, Centre Hospitalier Intercommunal de Créteil, F-94010 France
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  • J. Ameille

    1. AP-HP, Hôpital R. Poincaré, Unité de pathologie professionnelle, Garches, France
    2. Institut Interuniversitaire de Médecine du Travail de Paris Ile-de-France, Paris, F-75005, France
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A. Descatha
Unité de pathologie professionnelle
Hôpital Raymond Poincaré
92380
Garches
France

Abstract

Background:  Severity of occupational asthma at diagnosis is an important prognostic factor. The aim of this study was to determine which factors affect the severity of occupational asthma with a latency period at diagnosis.

Methods:  The study population consisted of 229 consecutive subjects with occupational asthma with a latency period recruited by four occupational health departments and divided into two groups according to the severity of the disease at diagnosis. The moderate-severe (FEV1 <70% predicted, or PD20 methacholine ≤300 μg; n = 101) and mild (FEV1≥70% predicted and PD20 methacholine >300 μg, n = 128) groups were compared in terms of clinical and demographic parameters. Multivariate analysis using logistic regressions was performed to examine factors associated with asthma severity.

Results:  Duration of symptoms before diagnosis was significantly longer in the moderate-severe group (mean ± SD: 6.3 ± 6.8 years vs 3.4 ± 4.4 years, P < 0.001). Sex ratio, age, atopy, smoking habits, duration of exposure before symptoms, and molecular weight of the causal agent were not significantly different between the two groups. On multivariate analysis, only duration of symptoms before diagnosis was associated with asthma severity (aOR = 1.12, 95% CI 1.05–1.18, P < 0.001).

Conclusions:  Severity of occupational asthma with a latency period at diagnosis was associated with duration of symptoms before diagnosis, but not with the type of causal agent. This finding emphasizes the need for early diagnosis and avoidance of exposure.

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