• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of oenvmedOccupational and Environmental MedicineCurrent TOCInstructions for authors
Occup Environ Med. May 1999; 56(5): 334–338.
PMCID: PMC1757733

Chronic rhinitis in workers at risk of reactive airways dysfunction syndrome due to exposure to chlorine

Abstract

BACKGROUND: To assess the frequency of chronic upper airways symptoms and to relate the presence of these symptoms to accidental exposure to chlorine and changes in lower airways symptoms, airway function, and bronchial responsiveness in a cohort of workers at risk of sporadic occupational exposure to high concentrations of chlorine. METHODS: Data were collected on symptom assessment, spirometry, and methacholine challenge tests from 211 workers seen twice at a 2 year interval (1992- 4). RESULTS: The proportion of workers reporting chronic rhinitis was 46.9% in 1992 and 42.2% in 1994. Chronic rhinitis reported in 1994 was significantly associated with acute exposure to chlorine (self reports, p = 0.02; first aid reports, p = 0.001). In a multivariate logistic regression analysis the presence of reported accidents at the first aid unit (one accident, odds ratio (OR) 3.1, 95% confidence interval (95% CI) 1.3 to 7.5; two or more accidents, OR 6.2, 1.1 to 35.8) and of personal atopy (OR 5.5, 2.2 to 10.8) were significant predictors of chronic rhinitis in 1994. Chronic lower airways symptoms were more frequent in 1994 among workers reporting chronic rhinitis on both assessments than in others (p = 0.03) and changes in bronchial responsiveness were more pronounced in those with persistent rhinitis (p = 0.09). CONCLUSIONS: These results suggest that persistent nasal symptoms in workers at risk of reactive airways dysfunction syndrome could be a useful marker of lower respiratory tract abnormalities.

 

Full Text

The Full Text of this article is available as a PDF (111K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Brooks SM, Weiss MA, Bernstein IL. Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures. Chest. 1985 Sep;88(3):376–384. [PubMed]
  • Alberts WM, do Pico GA. Reactive airways dysfunction syndrome. Chest. 1996 Jun;109(6):1618–1626. [PubMed]
  • Lemière C, Malo JL, Gautrin D. Nonsensitizing causes of occupational asthma. Med Clin North Am. 1996 Jul;80(4):749–774. [PubMed]
  • Meggs WJ. RADS and RUDS--the toxic induction of asthma and rhinitis. J Toxicol Clin Toxicol. 1994;32(5):487–501. [PubMed]
  • Brooks SM, Hammad Y, Richards I, Giovinco-Barbas J, Jenkins K. The spectrum of irritant-induced asthma: sudden and not-so-sudden onset and the role of allergy. Chest. 1998 Jan;113(1):42–49. [PubMed]
  • Salisbury DA, Enarson DA, Chan-Yeung M, Kennedy SM. First-aid reports of acute chlorine gassing among pulpmill workers as predictors of lung health consequences. Am J Ind Med. 1991;20(1):71–81. [PubMed]
  • Henneberger PK, Ferris BG, Jr, Sheehe PR. Accidental gassing incidents and the pulmonary function of pulp mill workers. Am Rev Respir Dis. 1993 Jul;148(1):63–67. [PubMed]
  • Henneberger PK, Lax MB, Ferris BG., Jr Decrements in spirometry values associated with chlorine gassing events and pulp mill work. Am J Respir Crit Care Med. 1996 Jan;153(1):225–231. [PubMed]
  • Gautrin D, Leroyer C, L'Archevêque J, Dufour JG, Girard D, Malo JL. Cross-sectional assessment of workers with repeated exposure to chlorine over a three year period. Eur Respir J. 1995 Dec;8(12):2046–2054. [PubMed]
  • Burney PG, Laitinen LA, Perdrizet S, Huckauf H, Tattersfield AE, Chinn S, Poisson N, Heeren A, Britton JR, Jones T. Validity and repeatability of the IUATLD (1984) Bronchial Symptoms Questionnaire: an international comparison. Eur Respir J. 1989 Nov;2(10):940–945. [PubMed]
  • Knudson RJ, Lebowitz MD, Holberg CJ, Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983 Jun;127(6):725–734. [PubMed]
  • Malo JL, Pineau L, Cartier A, Martin RR. Reference values of the provocative concentrations of methacholine that cause 6% and 20% changes in forced expiratory volume in one second in a normal population. Am Rev Respir Dis. 1983 Jul;128(1):8–11. [PubMed]
  • Sterk PJ, Fabbri LM, Quanjer PH, Cockcroft DW, O'Byrne PM, Anderson SD, Juniper EF, Malo JL. Airway responsiveness. Standardized challenge testing with pharmacological, physical and sensitizing stimuli in adults. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993 Mar;16:53–83. [PubMed]
  • O'Connor G, Sparrow D, Taylor D, Segal M, Weiss S. Analysis of dose-response curves to methacholine. An approach suitable for population studies. Am Rev Respir Dis. 1987 Dec;136(6):1412–1417. [PubMed]
  • Wolf DC, Morgan KT, Gross EA, Barrow C, Moss OR, James RA, Popp JA. Two-year inhalation exposure of female and male B6C3F1 mice and F344 rats to chlorine gas induces lesions confined to the nose. Fundam Appl Toxicol. 1995 Jan;24(1):111–131. [PubMed]
  • Demnati R, Fraser R, Plaa G, Malo JL. Histopathological effects of acute exposure to chlorine gas on Sprague-Dawley rat lungs. J Environ Pathol Toxicol Oncol. 1995;14(1):15–19. [PubMed]
  • Meggs WJ, Elsheik T, Metzger WJ, Albernaz M, Bloch RM. Nasal pathology and ultrastructure in patients with chronic airway inflammation (RADS and RUDS) following an irritant exposure. J Toxicol Clin Toxicol. 1996;34(4):383–396. [PubMed]
  • Lemière C, Malo JL, Boulet LP, Boutet M. Reactive airways dysfunction syndrome induced by exposure to a mixture containing isocyanate: functional and histopathologic behaviour. Allergy. 1996 Apr;51(4):262–265. [PubMed]
  • Gautrin D, Boulet LP, Boutet M, Dugas M, Bhérer L, L'Archevêque J, Laviolette M, Côté J, Malo JL. Is reactive airways dysfunction syndrome a variant of occupational asthma? J Allergy Clin Immunol. 1994 Jan;93(1 Pt 1):12–22. [PubMed]
  • Kennedy SM, Enarson DA, Janssen RG, Chan-Yeung M. Lung health consequences of reported accidental chlorine gas exposures among pulpmill workers. Am Rev Respir Dis. 1991 Jan;143(1):74–79. [PubMed]
  • Enarson DA, Johnson A, Block G, Maclean L, Dybuncio A, Schragg K, Chan-Yeung M, Grzybowski S. Respiratory health at a pulpmill in British Columbia. Arch Environ Health. 1984 Sep-Oct;39(5):325–330. [PubMed]
  • Kennedy SM, Enarson DA, Janssen RG, Chan-Yeung M. Lung health consequences of reported accidental chlorine gas exposures among pulpmill workers. Am Rev Respir Dis. 1991 Jan;143(1):74–79. [PubMed]
  • Becklake MR, Lalloo U. The 'healthy smoker': a phenomenon of health selection? Respiration. 1990;57(3):137–144. [PubMed]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • Compound
    Compound
    PubChem Compound links
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles
  • Substance
    Substance
    PubChem Substance links

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...