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Assessment of impairment/disability due to occupational asthma through a multidimensional approach

Dept of Chest Medicine, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada.

CORRESPONDENCE: J-L. Malo, Dept of Chest Medicine, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin West, Montreal, QC, H4J 1C5, Canada. Fax: 1 5143383123. E-mail: malojl{at}meddir.umontreal.ca

Keywords: Impairment/disability, occupational asthma, psychological stress, quality of life

Received: September 29, 2006
Accepted December 14, 2006

Subjects with occupational asthma (OA) are often left with permanent sequelae after removal from exposure, and assessing their impairment/disability should utilise various tools.

The aim of the present study was to examine whether: 1) assessment of inflammation in induced sputum is relevant to impairment; and 2) use of questionnaires on quality of life and psychological factors can be useful for the evaluation of disability. In total, 40 subjects were prospectively assessed for permanent impairment/disability due to OA 2 yrs after cessation of exposure. Impairment was assessed as follows: 1) need for asthma medication; 2) asthma severity; 3) airway calibre and responsiveness; and 4) degree of inflammation in induced sputum. Disability was assessed according to quality of life and psychological distress.

There was a significant improvement in airway responsiveness and inflammation from diagnosis to the present assessment. Sputum eosinophils 2% and neutrophils >60% were present in eight (20%) and 12 (30%) out of all subjects, respectively, one or the other feature being the only abnormalities in 15% of subjects. Quality of life was moderately affected and there was a prevalence of depression and anxiety close to 50%.

In the assessment of subjects with occupational asthma, information on airway inflammation and psychological impacts are relevant to the assessment of impairment/disability, although these findings need further investigation.

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