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Journal of Occupational & Environmental Medicine:
ORIGINAL ARTICLES: CME Article #1

Work-Related Reactive Airways Dysfunction Syndrome Cases from Surveillance in Selected US States

Henneberger, Paul K. MPH, ScD; Derk, Susan J. MA; Davis, Letitia ScD; Tumpowsky, Catharine MPH; Reilly, Mary Jo MS; Rosenman, Kenneth D. MD; Schill, Donald P. MS; Valiante, David MS, CIH; Flattery, Jennifer MPH; Harrison, Robert MD, MPH; Reinisch, Florence MPH; Filios, Margaret S. RN, ScM; Tift, Brian

Continued Medical Education
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Abstract

Learning Objectives:

* Distinguish between reactive airways dysfunction syndrome (RADS) and other cases of work-related asthma (WRA) associated with a known asthma-inducing agent.

* Contrast the clinical features, severity, and course of RADS with those of other WRA related to an identified asthma inducer.

* Identify differences in outcome and disposition between RADS and other WRA.

The objective was to elaborate the descriptive epidemiology of work-related cases of reactive airways dysfunction syndrome (RADS). Cases of work-related asthma (WRA) were identified in four states in the United States during 1993–1995 as part of the Sentinel Event Notification Systems for Occupational Risks (SENSOR). Information gathered by follow-back interview was used to describe 123 work-related RADS cases and to compare them to 301 other WRA cases whose onset of disease was associated with a known asthma inducer. RADS represented 14% of all new-onset WRA cases identified by the state SENSOR surveillance systems. RADS cases had significant adverse medical and occupational outcomes identified by follow-back interview. In particular, 89% still had breathing problems, 78% had ever sought emergency care and 39% had ever been hospitalized for work-related breathing problems, 54% had applied for worker compensation benefits, and 41% had left the company where they experienced onset of asthma. These values equaled or exceeded the comparable figures for those WRA cases whose onset was attributed to a known inducer. Work-related RADS represents a minority of all WRA cases, but the adverse impact of this condition appears to equal that of other WRA cases.

©2003The American College of Occupational and Environmental Medicine

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