A Framework for Assessing Impairment from Asthma: Determination of Disease Severity (6)

Zetterstrom et al first proposed this hypothesis when studying 129 coffee-roasting workers. They found that smokers were more likely to have positive skin tests to coffee beans and castor beans than nonsmokers. Smokers have been shown to be more likely to have specific IgE to a variety of other occupational antigens such as ispaghular extract, tetrachlorophthalic anhydride, and prawn antigen. However, such an increase in smoking-related specific IgE is not a universal finding in occupational asthma and has not been seen in western red cedar asthma — flovent inhaler.
An example of the smoldng-atopy relationship can be seen in the study of Cartier et al. These investigators studied snow crab workers and performed challenge tests on all workers with respiratory symptoms (Table 7). The overall prevalence of occupational asthma was 16%. Only 11% were atopic by skin test. Although the prevalence of occupational asthma was 25% in atopic subjects and only 14% in those without atopy, this difference was not statistically significant. However, occupational asthma was more common in cigarette smokers (20%) than in nonsmokers (9%).
Clinical Measures
A variety of clinical measures of asthma severity have been proposed (see Table 3).

Table 7—Prevalence of Occupational Asthma tn Snow Crab ‘Workers

Asthma
Prevalence
Subjects (%)
Atopic 16
Nonatopic 25
Smoking 20
Nonsmoking 9

Category: Asthma

Tags: Airway responsiveness, Asthma, bronchial responsiveness, lung function, smoking