By Malo, Jean-Luc
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Extra info for Asthma in the Workplace, Fourth Edition
First, asthma is usually a nonpermanent fluctuating condition, and its markers may be absent during the epidemiologic survey. Second, once sensitized to an asthmogenic agent or agents in the workplace, the individual reacts to a lower level of exposure, often because of the development and persistence of nonspecific bronchial hyperresponsiveness and latent inflammation. As a result, certain prevalence studies, and even incidence studies, may fail to identify levels responsible for provoking the onset of the condition (even if the affected individual has not quit the workplace location).
Barker RD, Van Tongeren MJ, Harris JM, et al. Risk factors for sensitisation and respiratory symptoms among workers exposed to acid anhydrides: a cohort study. Occup Environ Med 1998; 55: 684–91. 75. Nieuwenhuijsen MJ, Heederik D, Doekes G, Venables KM, Newman-Taylor AJ. Exposure-response relations to alphaamylase sensitisation in British bakeries and flour mills. Occup Env Med 1999; 56: 197–201. 76. Cullinan P, Cook A, Gordon S, et al. Allergen exposure, atopy and smoking as determinants of allergy to rats in a cohort of laboratory employees.
Am J Respir Crit Care Med 2004; 169: 1304–7. 96. Maghni K, Lemière C, Ghezzo H, Yuquan W, Malo JL. Airway inflammation after cessation of exposure to agents causing occupational asthma. Am J Respir Crit Care Med 2004; 169: 367–72. 97. Sumi Y, Foley S, Daigle S, et al. Structural changes and airway remodelling in occupational asthma at a mean interval of 14 years after cessation of exposure. Clin Exp Allergy 2007; 37: 1781–7. 98. Lemière C, Cartier A, Malo JL, Lehrer SB. Persistent specific bronchial reactivity to occupational agents in workers with normal nonspecific bronchial reactivity.