Assessing the Exacerbations Risk of Influenza-Associated Chronic Occupational Asthma

作者：Liao Chung Min^*; Hsieh Nan Hung; Chio Chia Pin; Chen Szu Chieh

来源：Risk Analysis, 2010, 30(7): 1062-1075.

DOI：10.1111/j.1539-6924.2010.01402.x

• Asthma
• detrended fluctuation analysis
• exacerbations risk
• influenza
• probabilistic risk assessment

The purpose of this article was to conduct a risk-based study based on a linkage of experimental human influenza infections and fluctuation analysis of airway function to assess whether influenza viral infection was risk factor for exacerbations of chronic occupational asthma. Here we provided a comprehensive probabilistic analysis aimed at quantifying influenza-associated exacerbations risk for occupational asthmatics, based on a combination of published distributions of viral shedding and symptoms scores and lung respiratory system properties characterized by long-range peak expiratory flow (PEF) dynamics. Using a coupled detrended fluctuation analysis-experimental human influenza approach, we estimated the conditional probability of moderate or severe lung airway obstruction and hence the exacerbations risk of influenza-associated occupational asthma in individuals. The long-range correlation exponent (alpha) was used as a predictor of future exacerbations risk of influenza-associated asthma. For our illustrative distribution of PEF fluctuations and influenza-induced asthma exacerbations risk relations, we found that the probability of exacerbations risk can be limited to below 50% by keeping alpha to below 0.53. This study also found that limiting wheeze scores to 0.56 yields a 75% probability of influenza-associated asthma exacerbations risk and a limit of 0.34 yields a 50% probability that may give a representative estimate of the distribution of chronic respiratory system properties. This study implicates that influenza viral infection is an important risk factor for exacerbations of chronic occupational asthma.

• 出版日期2010-7