Diisocyanate-Induced Asthma: Diagnosis, Prognosis, and Effects of Medical Surveillance Measures
Notice bibliographique
Résumé
Diisocyanates have been the most commonly identified cause for occupational asthma (OA) in industrialized areas. Asthma among diisocyanate workers may be true occupational asthma, caused by a high level of irritant exposure at work or by sensitization to diisocyanates. Alternatively, asthma may be coincidental to or may be aggravated by work exposures. A clear diagnosis usually requires a combination of investigations (serial peak expiratory flow recordings, methacholine challenges, and/or diisocyanate challenges), but it is important to provide the best management by identifying whether workplace changes are needed for the worker. Preventive measures to reduce the risk of occupational asthma from diisocyanates have not been prospectively evaluated. The introduction of a medical surveillance program (in Ontario, Canada) in 1983 was followed by retrospective assessments to determine benefits. Between 1980 and 1993, the proportion of all accepted compensation claims for OA that were attributed to diisocyanates, classified by year of symptom onset in the province with the program, rose to 64 percent by 1988, then fell significantly down to 29 percent in 1992 and 35 percent in 1993. Besides the medical surveillance program for diisocyanates, possible factors contributing to this reduction may include reduced diisocyanates exposures and better awareness of diisocyanate-induced asthma, both by workers and physicians. Compared with OA caused by other agents, those with OA due to diisocyanates had a significantly earlier onset of asthma after the start of the exposure (mean 5 yr vs. 7 yr), were younger and less likely to be atopic and to have smoked. The mean duration of asthma before the main medical assessment for compensation was significantly shorter among those with diisocyanate-induced asthma (mean 2 yr vs. 3 yr), and the severity was milder as assessed by medication use and pulmonary function. Those with diisocyanate-induced asthma were significantly less likely to be hospitalized for asthma. Among the subset whose outcome was determined at a mean of 2.1 years after the main medical assessment, the outcome severity was less for those with diisocyanate-induced OA. Among those with diisocyanate-induced OA, an earlier diagnosis and a trend to better outcome was found in workers from companies that were identified to be in compliance with surveillance measures.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».