Assessing the Exacerbations Risk of Influenza‐Associated Chronic Occupational Asthma

Liao, Chung‐Min; Hsieh, Nan‐Hung; Chio, Chia‐Pin; Chen, Szu‐Chieh

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 (α) 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 α 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.