[Significance of exposure tests in diagnosis of occupational asthma].

Pneumonologia polska Pub Date : 1990-07-01
L Kuś, J Milanowski, B Fafrowicz
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Abstract

Twenty-eight patients aged from 32 to 60 years, including 18 female and 10 male, were examined because of bronchial asthma suspicion. They were employed in different professions, but more of them worked as baker or nurse. An occupation time was from 11 to 32 years, but first symptoms of bronchial asthma were noticed after 7-28 (mean 14 yrs.) years of work. At all patients the exposure test (inhalatory challenge) with some substances selected by disease history was performed. This above mentioned substances were mechanically polluted in air to simulate an occupational circumstances. The exposure was persisted from 5 to 30 minutes, according to observed disease symptoms. Spirometric tests were performed in 2 and 30 minutes after exposure, but in baker group also in 4 and 8 hours. At 26 patients a decrease higher than 20% of starting values of FEV1 was determined. In most cases there were immediate reactions, and at baker group--dual reactions. At two examined subjects no response of bronchial tree was observed but only burning of mucosa and cutaneous pruritus. For this reason at this group a diagnose of allergy to examined substances was established. Other ones 26 patients were diagnosed as occupational bronchial asthma.

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[暴露试验在职业性哮喘诊断中的意义]。
28例患者年龄32 ~ 60岁,其中女性18例,男性10例。他们从事不同的职业,但更多的是面包师或护士。职业时间为11 ~ 32年,但支气管哮喘的首次症状在工作7 ~ 28年(平均14年)后才出现。所有患者均进行了根据病史选择一些物质的暴露试验(吸入挑战)。上述物质在空气中被机械污染以模拟职业环境。根据观察到的疾病症状,暴露持续5至30分钟。暴露后2分钟和30分钟进行肺活量测定,但baker组也在4小时和8小时进行肺活量测定。26例患者的FEV1下降幅度大于初始值的20%。在大多数情况下,有直接反应,在贝克群-双重反应。在两个检查对象中,没有观察到支气管树的反应,但只有粘膜灼烧和皮肤瘙痒。因此,在这一组中建立了对所检查物质过敏的诊断。另有26例诊断为职业性支气管哮喘。
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