Outcome of occupational asthma after cessation of exposure: a systematic review

Thorax
George RachiotisPaul Cullinan

Abstract

Patients with occupational asthma, and their medical advisers, need valid information about the prognosis of their disease. A systematic review of the published literature on the symptomatic and functional outcomes of occupational asthma was carried out after avoidance of exposure to the causative agent. Through a full search of electronic and bibliographic sources, original studies documenting complete recovery from asthma (n = 39,1681 patients) or improvement in non-specific bronchial hyper-responsiveness (NSBHR; n = 28,695 patients) were identified. The median duration of follow-up was 31 (range 6-240) months for studies of symptomatic recovery and 37 (6-240) months for studies of NSBHR. Most studies were of patients recruited from special clinics. Reported rates of symptomatic recovery varied from 0% to 100%, with a pooled estimate of 32% (95% CI 26% to 38%). These rates were lower with increasing age (p = 0.019) and among clinic based populations (p = 0.053). Patients with the shortest durations of exposure (< or =76 months) had the highest rate of recovery (36%; 95% CI 25% to 50%), but the effect was not linear. The pooled prevalence of persistent NSBHR at follow-up was 73% (95% CI 66% to 79%). This figure was higher amon...Continue Reading

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