US EPA

74250 

Journal Article 

Reactive airways dysfunction syndrome (RADS: Persistent asthma syndrome after high level irritant exposures 

Brooks, SM; Weiss, MA; Bernstein, IL 

1985 

Yes 

Chest
ISSN: 0012-3692
EISSN: 1931-3543 

NIOSH/00210295 

88 

3 

376-384 

English 

4028848 

10.1378/chest.88.3.376 

WOS:A1985AQC0700015 

http://://WOS:A1985AQC0700015
Exit
 

Ten individuals developed an asthma-like illness after a single exposure to high levels of an irritating vapor, fume, or smoke. In most instances, the high level exposure was the result of an accident occurring in the workplace or a situation where there was poor ventilation and limited air exchange in the area. In all cases, symptoms developed within a few hours and often minutes after exposure. We have designated the illness as reactive airway dysfunction syndrome (RADS) because a consistent physiologic accompaniment was airways hyperreactivity. When tested, all subjects showed positive methacholine challenge tests. No documented preexisting respiratory illness was identified nor did subjects relate past respiratory complaints. In two subjects, atopy was documented, but in all others, no evidence of allergy was identified. In the majority of the cases, there was persistence of respiratory symptoms and continuation of airways hyperreactivity for more than one year and often several years after the incident. The incriminated etiologic agent varied, but all shared a common characteristic of being irritant in nature. In two cases, bronchial biopsy specimens were available, and an airways inflammatory response was noted. This investigation suggests acute high level, uncontrolled irritant exposures may cause an asthma-like syndrome in some individuals which is different from typical occupational asthma. It can lead to long-term sequelae and chronic airways disease. Nonimmunologic mechanisms seem operative in the pathogenesis of this syndrome. 

DCN-210049; Respiratory system disorders; Occupational diseases; Pathogenesis; Clinical symptoms; Case studies; Occupational exposure; Environmental exposure; Respiratory irritants; Airway obstruction