Original articleFollow-up study of 232 patients with occupational asthma caused by western red cedar (Thuja plicata)
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Evolution of occupational asthma: Does cessation of exposure really improve prognosis?
2014, Respiratory MedicineCitation Excerpt :In fact, the patients who improved were the ones who presented poorer classifications on the GINA at the time of diagnosis, regardless of whether or not they avoided exposure. Delay in diagnosis, the degree of intensity of the symptoms prior to diagnosis and patients' age have been suggested as prognostic factors [7,29–33] that determine the persistence of asthma. In the present study, avoidance of exposure to the causative agent and a lower degree of bronchial obstruction may explain the improvement in symptoms, although the associations were not significant.
Treatments used in complementary and alternative medicine
2012, Side Effects of Drugs AnnualCitation Excerpt :In another case there was a raised concentration of serum IgE to plicatic acid [66A]. Of 232 patients with red cedar asthma diagnosed by inhalation provocation tests, 96 continued to work with red cedar, and 136 left the industry and had no further exposure; of the latter, only 55 recovered completely, and the other 81 continued to have attacks of asthma of varying severity [67C]. Nervous system A mixture of Dioscoreae rhizoma Nipponicae and Ficus formosana has been reported to be associated with a cholinergic reaction [68A].
Work-Related Asthma: A Case-Based Approach to Management
2011, Immunology and Allergy Clinics of North AmericaCitation Excerpt :One study of 25 patients with OA, of whom 22 had asthma caused by an LMW chemical, showed no significant differences in the percentage of predicted forced expiratory volume in 1 second or methacholine PD20 compared with baseline for the 12 patients who remained in their jobs, or the 13 with more severe disease who left employment.15 Nonetheless, the outcome of LMW asthma in patients who are not removed from exposure is often one involving persistent symptoms, need for medication, and bronchial hyperresponsiveness, as in isocyanate-induced asthma31,32 and western red cedar asthma.4,33 A review of 10 fatal asthma cases identified isocyanates, a common LMW antigen, as the cause in 3.34
Remission of asthma: The next therapeutic frontier?
2011, Pharmacology and TherapeuticsCitation Excerpt :However, this appears to occur in a minority of cases, possibly related to initial prolonged exposure, initiation of mechanisms of long-lasting and independent pathology or to the unmasking of a pre-existing airway abnormality. Persistence of symptoms, usually associated with AHR, occurs in 60% or more of patients despite prolonged withdrawal from sensitisers such as Western Red Cedar (Chan-Yeung et al., 1987) or toluene diisocyanate (Paggiaro et al., 1984) or in snow crab workers (Malo et al., 1988). Interestingly symptoms persisted in patients exposed to tetrachlorophthalic anhydride (TCPA) despite prolonged withdrawal of exposure and exponential decline in serum levels of specific IgE to TCPA (Venables et al., 1987), suggesting other factors might account for the persistence of asthma.
Quality of life and employment status of workers with western red cedar asthma
2007, Journal of Occupational and Environmental MedicineWorkplace interventions for treatment of occupational asthma
2019, Cochrane Database of Systematic Reviews
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P. L. Paggiaro, M.D., is a visiting scientist whose present address is Ricercatore Universitario in Medicina del Lavoro, dell'Universita di Pisa, Fisiopatologia Respiratoria, Clinica, Medica 2, Pisa via Roma 57, Italy 56100 Pisa.