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Asthma Not Worsened by Continued Trigger Exposure

Mon Jan 19, 2004

NEW YORK (Reuters Health) - You might think that people with asthma that's triggered by a specific environmental compound would have to avoid that environment, otherwise their asthma would get worse and worse.

Not so, it seems.

Asthma does not appear to worsen in patients with continued exposure to the causative agent -- as long as treatment with steroids and long-acting bronchodilators is maintained, physicians in Italy report.

Changing jobs is not an option for many people who develop occupational asthma, Dr. Alessandra Marabini and colleagues at the University of Perugia note in their report, published in the medical journal Chest. They therefore conducted a study to examine what happens with continued exposure while asthma patients are being treated.

Marabini's team followed 20 patients with mild to moderate work-related asthma, treated with the inhaled steroid beclomethasone dipropionate and the bronchodilators salmeterol. During three years of follow-up, six patients retired and four changed jobs for reasons other than worsening asthma.

The 10 subjects remaining in the study saw no significant changes in lung function or asthma symptoms, the authors report.

Therefore, Marabini and colleagues suggest that "an attempt be made to encourage workers to retain their employment rather than just advising them to leave their jobs" -- while recommending reduced exposure to the agent that causes their asthma, use of appropriate personal protection devices, and continued treatment.

However, they add, such patients should be monitored frequently "and removed from exposure in case of respiratory deterioration."

SOURCE: Chest, December 2003.

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