Reactive airways dysfunction syndrome acquired in a farming environment: an underestimated entity

Reactive airways dysfunction syndrome has been recognized as a clinical ent ity for the last ten years. It corresponds to persistent bronchial hyperres ponsiveness with asthma-like dyspnoea, occurring after a single episode of massive inhalation of irritant gases, smoke, or vapour, in subjects not pre senting any pre-existing respiratory tract disease. The authors report the case of a non-smoking farmer, with no history of respiratory tract or atopi c disease, who developed immediate bronchial symptoms following accidental exposure to a mixture composed of sulphuric acid, phosphoric acid and chlor ine at his workplace. No frank alteration of baseline respiratory function was observed, but the patient presented bronchial hyperresponsiveness on th e methacholine test, persisting for one year after the initial accident. In dustrialization of the farming sector predisposes to the use of toxic subst ances, which can be responsible for such diseases. Rapid declaration as a w ork accident is necessary to ensure correct management of patients, who may develop severe chronic obstructive pulmonary disease.