BACKGROUND: Although airbags are a significant development in automobile safety, they have brought with them new medical problems. OBJECTIVE: To describe a case of new-onset asthma occurring after exposure to a deployed airbag's contents. METHODS: A 47-year-old man had a 2.5-year history of chest tightness, decreased exercise tolerance, and nocturnal and activity-associated cough beginning after a head-on motor vehicle collision when he was driving an automobile equipped with dual driver-passenger airbags. The collision activated both airbags, with the driver's side airbag breaking open, filling the automobile with particulates. The driver remained in the car for 3 minutes and developed acute shortness of breath and chest tightness for the first time in his life. He had a smoking history of 1 pack-year 20 years earlier. Before that time he could exercise frequently, running for 30 minutes almost daily without difficulty. After the collision, he had respiratory symptoms at rest and after exercise, requiring daily control and rescue medication. Subsequently, he developed bronchospasm following exposure to nonspecific agents, which he had never previously experienced. RESULTS: Skin test reactivity was detectable only to dust mite. Methacholine challenge results were markedly positive at 8 weeks and 2.5 years after the incident. Video laryngoscopy revealed normal vocal cord appearance and function. CONCLUSIONS: Our patient represents the first case, to our knowledge, of new-onset, persistent, irritant-induced asthma following airbag deployment. Physicians should be aware of its possibility after airbag exposure, since prompt institution of aggressive therapy may improve patient outcome and dampen or prevent persistent disease.
BACKGROUND: Although airbags are a significant development in automobile safety, they have brought with them new medical problems. OBJECTIVE: To describe a case of new-onset asthma occurring after exposure to a deployed airbag's contents. METHODS: A 47-year-old man had a 2.5-year history of chest tightness, decreased exercise tolerance, and nocturnal and activity-associated cough beginning after a head-on motor vehicle collision when he was driving an automobile equipped with dual driver-passenger airbags. The collision activated both airbags, with the driver's side airbag breaking open, filling the automobile with particulates. The driver remained in the car for 3 minutes and developed acute shortness of breath and chest tightness for the first time in his life. He had a smoking history of 1 pack-year 20 years earlier. Before that time he could exercise frequently, running for 30 minutes almost daily without difficulty. After the collision, he had respiratory symptoms at rest and after exercise, requiring daily control and rescue medication. Subsequently, he developed bronchospasm following exposure to nonspecific agents, which he had never previously experienced. RESULTS: Skin test reactivity was detectable only to dust mite. Methacholine challenge results were markedly positive at 8 weeks and 2.5 years after the incident. Video laryngoscopy revealed normal vocal cord appearance and function. CONCLUSIONS: Our patient represents the first case, to our knowledge, of new-onset, persistent, irritant-induced asthma following airbag deployment. Physicians should be aware of its possibility after airbag exposure, since prompt institution of aggressive therapy may improve patient outcome and dampen or prevent persistent disease.
Authors: John Tat; Karen Heskett; Shiho Satomi; Renate B Pilz; Beatrice A Golomb; Gerry R Boss Journal: Clin Toxicol (Phila) Date: 2021-06-15 Impact factor: 4.467