Dupas D, Vignon M, Bataille A
CHR de Nantes.
Allerg Immunol (Paris). 1995 Feb;27(2):55-8.
The occupational origin of asthma is only found only late, from a diagnosis delay due to development. The aim of this work was to study the chronological characteristics of occupational asthma of different etiologies and to understand the occupational after-effects. A series of 144 cases were analysed (115 men and 29 women) who were seen in a consultation that specialised in occupational pathology, with the inclusion criteria those of the National Institute for Occupational Safety and Health (NIOSH). The analysis was based on: the causative allergen or work protocol; the role of atopy; length of the latency phase; length of symptom exposure; diagnosis delay; occupational consequences. Asthma from isocyanates and flour between them accounted for 62% in this series. These were followed by asthma from wood (8.3%) and persulphates (7.6%). The mean length of the latency period was 7.5 years and the mean diagnosis delay was 2.5 years. Clinical history of atopy and the existence of rhinitis were much more common for the "biological" than the "chemical" asthmas (respectively 69% and 95%, against 36% and 15%). Amongst the 64% of patients who benefited from complete removal of the allergen, 78.5% who were cured or improved, though for those who kept the same conditions of work there was a persistence or even aggravation of symptoms. In 74 cases a certificate of occupational illness was given to the patient.
职业性哮喘的病因很晚才被发现，这是由于病情发展导致诊断延迟。这项研究的目的是探讨不同病因的职业性哮喘的时间特征，并了解其职业后遗症。我们分析了144例病例（115名男性和29名女性），这些病例均来自一家职业病理专科门诊，纳入标准符合美国国家职业安全与健康研究所（NIOSH）的标准。分析基于以下方面：致病过敏原或工作流程；特应性的作用；潜伏期长度；症状暴露时长；诊断延迟；职业后果。在该系列病例中，异氰酸酯和面粉引发的哮喘占62%。其次是木材（8.3%）和过硫酸盐（7.6%）引发的哮喘。平均潜伏期为7.5年，平均诊断延迟为2.5年。“生物性”哮喘患者的特应性临床病史和鼻炎的发生率比“化学性”哮喘患者更为常见（分别为69%和95%，而化学性哮喘分别为36%和15%）。在64%的完全去除过敏原的患者中，78.5%的患者治愈或病情改善，然而，对于那些工作条件不变的患者，症状持续存在甚至加重。74例患者获得了职业病诊断证明。
