Korean J Occup Environ Med.  2008 Dec;20(4):372-378.

A Case of Reactive Airways Dysfunction Syndrome in a Synthetic Resin Manufacture Factory

• Park SY
• Lee JS
• Kim BW
• Lee JO
• Park KC
• Choi BS

Abstract

BACKGROUND: Reactive airways dysfunction syndrome (RADS), which represents between 5% and 18% of new-onset, work-related asthma, remains underreported in spite of increasing reports of occupational asthma cases through occupational asthma surveillance in Korea. We report a 61-year-old male who developed RADS after exposure to a high level of toxic gases from a workplace accident. CASE: The patient who had worked for 21 years at a PVC manufacture factory and had retained good health until Aug 22, 2007, when he was exposed to PVC (polyvinyl chloride), DEHP (Di (2-Ethylhexyl) Phthalate), dibutyl tin maleate and epoxidized soybean oil gases from a heated mixer. Within several minutes of exposure, he developed coughing, rhinorrhea, dyspnea and wheezing. Pulmonary function tests (PFTs) showed an FVC of 3.81 L(82% of predicted), FEV1 of 1.63 L/s (50% of predicted), FEV1/FVC% of 43 %, and FEV1 of 1.80 L/s that increased by 170 ml and 10.4% in response to bronchodilator. After 7 months of treatment with inhaled steroids and bronchodilators, repeat PFTs showed an FVC of 6.56 L(143.5% of predicted), FEV1 of 3.21 L(99.3% of predicted), and FEV1/FVC% of 48.9%. A methacholine challenge test was negative at a concentration of 25 mg/ml.
CONCLUSION
RADS occurred due to exposure to raw material vapors or their thermal decomposition products.

Keyword

Reactive airways dysfunction syndrome; Polyvinyl chloride; Di (2-Ethylhexyl) Phthalate

MeSH Terms

Asthma
Asthma, Occupational
Bronchodilator Agents
Cough
Diethylhexyl Phthalate
Dyspnea
Gases
Hot Temperature
Humans
Korea
Male
Maleates
Methacholine Chloride
Middle Aged
Polyvinyl Chloride
Resins, Synthetic
Respiratory Function Tests
Respiratory Sounds
Soybean Oil
Steroids
Tin
Bronchodilator Agents
Diethylhexyl Phthalate
Gases
Maleates
Methacholine Chloride
Polyvinyl Chloride
Resins, Synthetic
Soybean Oil
Steroids
Tin