REACTIVE AIRWAYS DYSFUNCTION SYNDROME (RADS) AFTER HIGH LEVEL IRRITANT EXPOSURES

Abstract

To identify those agents as being associated with reactive airways dysfunction syndrome (RADS) that should raise awareness of this potential risk in that work environment. A systematic case reporting was undertaken. Patients with occupational asthma were screened and selected against pre-determined diagnostic criteria for RADS. The clinical, functional and occupational evolution was evaluated. Of 19 patients who met Brooks' criteria, 14 male and 5 female with median age was 37.8 years. The proportion of non-atopic and smokers was higher. Most exposures occurred in the workplace was accidental. The reported agents were chlorine, toluene di-isocyanate (TDI), oxides of nitrogen, acetic acid, paint and sulfuric acid. Dyspnoea, cough and wheeze were the commonest symptoms. Symptoms developed within 5 to 24 hours and symptom duration was 5 to 30 months in all subjects. FEV1% <80% and X-ray report was normal in all cases. With regard to the clinical evolution, there was an improvement and patients who inhaled in the workplace continued working. There is lack of adequate information about RADS that can better explore it. A more structured approach to gathering information on exposure, investigation and outcome is required. A minimum data set for reporting RADS cases is proposed. We suggest that a web-based database of RADS cases be established which would allow continuous update and better analysis of outcome in these individuals.