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Occupational Medicine Advance Access published online on February 27, 2008
Occupational Medicine, doi:10.1093/occmed/kqn013
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Which agents cause reactive airways dysfunction syndrome (RADS)? A systematic review

M. S. Shakeri1, F. D. Dick2 and J. G. Ayres2

1 Department of Occupational Heath, Province Health Centre, Mazandaran University of Medical Science, Sari, Iran
2 Department of Environmental & Occupational Medicine, Institute of Applied Health Sciences, School of Medicine, University of Aberdeen, Aberdeen, UK

Aim: To identify those agents reported as being associated with reactive airways dysfunction syndrome (RADS).

Methods: A systematic review was undertaken. Abstracts were screened and those selected reviewed against pre-determined diagnostic criteria for RADS.

Results: Significant information gaps were identified for all measures of interest. In some articles, even the causative agent was not reported. The most commonly reported agents were chlorine (nine subjects), toluene di-isocyanate (TDI) (n = 6) and oxides of nitrogen (n = 5). Most exposures occurred in the workplace (n = 51) and affected men (60%). Dyspnoea (71%) and cough (65%) were the commonest symptoms. Median symptom duration was 13 months (interquartile range = 6.5–43.5) for RADS.

Conclusions: Although the most commonly reported agent associated with RADS was chlorine, the main finding of a general lack of adequate information on exposure, investigation and outcome suggests that to better explore RADS a more structured approach to gathering information is required. A minimum data set for reporting RADS cases is proposed.

Keywords      Asthma; irritant-induced asthma; reactive airways dysfunction

Correspondence to: Jon Ayres, Department of Environmental & Occupational Medicine, Liberty Safe Work Research Centre, Institute of Applied Health Sciences, School of Medicine, University of Aberdeen, Foresterhill Road, Aberdeen AB25 2ZP, UK. Tel: +44 1224 558188; fax: +44 1224 551826; e-mail: j.g.ayres{at}abdn.ac.uk


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