Introduction: Asthma is a chronic inflammatory disorder of the airways. Adult onset asthma generally refers to the onset of asthma for the first time in some one of middle age or older. It is more common in females. It is postulated to be due to the effect of sex hormones in women. Studies have shown that women with adult onset asthma have increased risk of coronary heart disease and stroke. The aim of the study was to study the clinical profile and pulmonary function abnormalities in these patients, find out the aetiological factors for adult onset asthma in these patients and to know whether late onset asthma has any relation with coir industry which is a common industry in this area.

Materials and Methods: Fifty female patients presenting with episodic wheezing with the onset of symptoms after the age of 40 years were included in the study. A detailed history, physical examination, blood investigations including the absolute eosinophil count, chest radiography and pulmonary function tests were done in them. Skin tests were done only in those patients with history of allergy.

Observations: In our study majority of the patients were in the age group 40-49 and 50-59 years. Age of onset of symptoms was below 50 years for 46% of patients. 82% patients were living in costal ares.30 patients (60%) reported history of allergic rhinitis. Of the total 30 patients with allergic rhinitis, 46% had onset of asthma symptoms before 50 years of age and 80% of patients had asthma symptoms before 60 years. FEV1 values were analyzed in relation with age of patient and duration of symptoms and no correlation was found. FEV1 reversibility was less in coir workers compared to housewives. Patients in the older age group had lower PEF 25-75 values compared to those in the younger age group. Allergy testing was done in 10 patients, of this 4 patients were found to be sensitive to various allergens like house dust, wheat dust etc. All these 4 patients had allergic rhinitis.

Conclusions: Allergic symptoms are common in these patients and atopy may be a reason for development adult onset asthma. In women exposure to kitchen smoke could be an etiological factor for development of asthma. Adult onset asthma was found to be more common in workers in coir industry. FEV1 reversibility was less in coir workers compared to other occupational groups. Small air way dysfunction was more common in older age group patients with late onset asthma.

Keywords: Late onset asthma.

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Dr Ambili NR

Assistant Professor, Dept of Medicine, Govt TD Medical College,

Vandanam PO, Alappuzha 688005

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