Abstract Rationale The specific patient related factors affecting the clinical course of reactive airways dysfunction syndrome (RADS) from occupational or environmental exposure remain poorly defined. We hypothesized that patients with RADS secondary to infectious etiologies would have a more rapid recovery in Asthma control test (ACT) scores compared to those patients with RADS due to occupational exposure to irritants or chemicals. Methods From an occupational exposure clinic cohort, n = 37 patients with RADS and multiple ACT scores over time were included. Patient demographics, laboratory data, and diagnostic testing were collected and analyzed. Trends were identified and differences were analyzed with two-sample T-tests to determine statistical significance. Results In patients with workplace-exacerbated asthma, there was a non-statistically significant improvement in final ACT scores in males (p = 0.09) and in those patients without comorbid GERD (p = 0.13). In patients with RADS without pre-existing asthma who achieved a final ACT score of 19 or greater, 5/9 had infectious etiologies for their mechanism of injury; whereas, in patients who did not achieve an ACT score of 19 or greater, 7/8 had a non-infectious inhalational occupational exposure related to an irritant or chemical exposure. There did not appear to be any difference in ACT score trends when stratifying the population by BMI, age, or peripheral eosinophil counts. Conclusion In the group of patients with workplace exacerbated asthma, male asthma patients had a greater improvement in ACT scores compared to female asthma patients. Patients with an infectious etiology for RADS appeared more likely to improve than those with occupational exposure to irritants or chemicals. Patients with GERD appeared to have worse recovery of ACT scores. Determining additional factors or biomarkers associated with worse recovery from workplace-exacerbated asthma or RADS within occupational cohorts is deserving of further study. This abstract is funded by: None
Rawlings et al. (Fri,) studied this question.