Quality of Life and Capsaicin Sensitivity in Patients with Airway Symptoms Induced by Chemicals and Scents: A Longitudinal Study Ewa Ternesten-Hasséus, Olle Lowhagen, and Eva Millqvist Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden Abstract Objective: It is common in asthma and allergy clinics to see patients presenting with upper and lower airway symptoms that are induced by chemicals and scents and not explained by allergic or asthmatic reactions. Previous studies have shown that these patients often have increased cough sensitivity to inhaled capsaicin ; such sensitivity is known to reflect the airway sensory reactivity. The aim of this study was to evaluate the duration of symptoms induced by chemicals and scents and to measure health-related quality of life (HRQL) in patients with chemically induced airway symptoms. We also wished to determine and compare repeatability of the cough response to capsaicin inhalation, and to evaluate the patients' airway sensory reactivity in a long-term perspective. Participants: Seventeen patients with a history of at least 12 months of airway symptoms induced by chemicals and scents were followed over 5 years with repeated questionnaires, measurements of HRQL, and capsaicin inhalation tests. Results: The symptoms persisted and did not change significantly over time, and the patients had a reduced HRQL that did not change during the 5-year period. The capsaicin sensitivity was increased at the start of the study, the cough sensitivity was long-lasting, and the repeatability of the capsaicin inhalation test was considered to be good in a long-term perspective. Conclusions: Upper and lower airway symptoms induced by chemicals and scents represent an entity of chronic diseases, different from asthma or chronic obstructive pulmonary disease, with persistent symptoms, a reduced HRQL, and unchanged sensory hyperreactivity. Key words: asthma, capsaicin, cough, environment, health-related quality of life, multiple chemical sensitivity, sensory hyperreactivity. Environ Health Perspect 115:425–429 (2007) . doi:10.1289/ehp.9624 available via http://dx.doi.org/ [Online 19 December 2006] Address correspondence to E. Ternesten-Hasséus, Asthma and Allergy Research Group, Department of Respiratory Medicine and Allergology, The Sahlgrenska Academy at Göteborg University, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden. Telephone: 46 31 3424577. Fax: 46 31 820518. E-mail: ewa.ternesten@lungall.gu.se We thank M. Wallgren for help with the capsaicin preparations. This study was supported by grants from the Vårdal Foundation, the Regional Health Care Authority of West Sweden, and the Swedish Heart and Lung Foundation. The authors declare they have no competing financial interests. Received 17 August 2006 ; accepted 19 December 2006. The full version of this article is available for free in HTML or PDF formats. |