Japanese Journal of Allergology

To estimate the effect of treatment and for patient education, we recommend 8 weeks PFM for all asthmatics when we start their treatments. To elucidate clinical characteristics of asthmatics who stop PFM, we analyzed 311 patients (145 males aged 15-76 years and 166 females aged 17-79 years) who could measure their PEFs twice daily for more than 8 consecutive weeks. The analysis of cumulative continuation rate of PEF monitoring revealed that the patients' withdrawal rate was 19% per year. The sixty asthmatics who gave up monitoring their PEFs (group A) showed significantly younger present ages (38.8±14.2, mean±S.D.) and younger ages of onset of their astma (29.8±19.6) than the other 251 asthmatics who could continue to monitor their PEFs (group B). The present ages and ages of onset of asthma of group B were 46.2±16.7 and 37.6±21.2 years, respectively. Despite no significant differences in the severity of the asthma based on both clinical symptoms and PEF between groups A and B, the asthma severity based only on the clinical symptoms of group A were significantly less than those of group B. The analysis of Cox's proportional hazards model revealed that major factors which influence patients' stopping of PFM were present age and severity of their asthma which was estimated by the patients' symptoms only, without PEF assessment. These results suggest that asthmatics whose present age is young and whose ability of perception of asthma is poor will be apt to stop PFM.

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Formaldehyde(FA) is an occupational and general indoor hazard often affecting the respiratory airways. One of the main causes of multiple chemical sensitivity is gaseous FA, and it has become an important social problem in developed countries. FA concentrations in anatomy dissection classrooms are thought to be higher than under usual circumstances. The number of students developing physical symptoms during the anatomy dissection course in our university has been increasing over recent years. We planned to clarify the causes of such symptoms. Ninety-five medical students were interviewed using a questionnaire about allergic histories, physical symptoms developed during the anatomy dissection course, and symptoms related to chemical sensitivity up to three months after the course had finished. We measured total IgE, specific IgE to FA and specific IgE to house dust mites. Eighty-three percent of students had experienced symptoms, such as burning eyes, nasal discharge, sore throat, general fatigue or skin irritation during the course. Fifty percent of students had a past history of atopic disease. Fifty-eight percent of students tested positive to specific IgE to house dust mites;however, only one student, who did not complain of any symptoms during the course, tested positive to FA-IgE. Students with atopic factors (Present histories of atopic diseases and higher total IgE) and/or chemical sensitivity demonstrated worse physical symptoms during the anatomy dissection course than students without such histories. In conclusion, it is suggested that gaseous FA exposure may exacerbate basic allergic symptoms, and moreover that people with chemical sensitivity demonstrated worse symptoms following gaseous FA exposure. Nevertheless, in our study we find no relationship between FA-IgE and the physical symptoms of gaseous FA exposure during or following an anatomy dissection course.

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