Allergy and Immunotoxicology Unit, CeSI, G. d'Annunzio University Foundation, Via Colle dell'Ara, 66100, Chieti, Italy.
Int Arch Occup Environ Health. 2012 Feb;85(2):181-8. doi: 10.1007/s00420-011-0653-4. Epub 2011 Jun 4.
In asthmatics, a rapid decline in pulmonary function is observed, likely as a consequence of airways remodeling. Persistence of allergen exposure in patients with occupational asthma (OA) maintains chronic bronchial inflammation, resulting in a more severe lung function decline. Few studies were performed on the effects of allergen exposure cessation.
This study aims at evaluating the influence of allergen exposure cessation on respiratory decline in allergic asthmatic workers.
Two groups of workers with allergic OA were selected. The first group (30 workers) changed job after the diagnosis and was no more exposed to sensitizing allergens, and the second group (28 subjects) did not and, as a consequence of preventive measures in the work place, was exposed to a lower level of allergens. All were treated with conventional therapy, according to GINA protocols. FEV1 changes during a 12-year period were evaluated.
Despite pharmacological therapy, the pulmonary function decay slope was steeper in workers continuously exposed to the sensitizing agent (even at reduced level) than in those with a complete cessation of exposure: final FEV1 loss was 512.5 ± 180 ml versus 332.5 ± 108 ml, respectively. The difference became significant after 4 years from the cessation of the exposure.
The study shows that the cessation of the exposure to allergen in the work place appears the most effective measure in limiting pulmonary function decline in asthmatic workers and underlines the importance of allergic risk assessment and control in the management of occupational asthma.
在哮喘患者中，肺功能迅速下降，可能是气道重塑的结果。职业性哮喘（OA）患者持续暴露于过敏原会导致慢性支气管炎症，从而导致更严重的肺功能下降。关于过敏原暴露停止的影响，很少有研究进行。
本研究旨在评估过敏原暴露停止对过敏性哮喘工人呼吸下降的影响。
选择两组过敏性 OA 工人。第一组（30 名工人）在诊断后更换工作，不再接触致敏过敏原，第二组（28 名受试者）未更换工作，由于工作场所的预防措施，接触的过敏原水平较低。所有患者均根据 GINA 方案接受常规治疗。评估了 12 年期间 FEV1 的变化。
尽管进行了药物治疗，但持续接触致敏剂（即使接触水平较低）的工人的肺功能下降斜率更陡峭：最终 FEV1 损失分别为 512.5±180ml 和 332.5±108ml。这种差异在停止接触后 4 年变得显著。
该研究表明，停止工作场所过敏原暴露似乎是限制哮喘工人肺功能下降的最有效措施，并强调了在职业性哮喘管理中进行过敏风险评估和控制的重要性。
