In case 2, despite of
the medical staff ’s recommendation, he refused further
accurate evaluation. Therefore we could not evaluate for
bronchial hyperresponsiveness. But his FEV1 after treatment
(93%) increased by 25% compared to initial FEV1
(68%). If FEV1 increased after treatment, it indicates the
possibility of asthma [13]. Taking these clinical features
into consideration, the investigators diagnosed both cases
as chlorine-induced RADS [14,15]. RADS is a type of
irritant-induced asthma without a latency period [16,17].
RADS was defined by Brooks et al. in 1985 [18] as having
the following diagnostic characteristics: (1) a documented
absence of preceding respiratory complaints; (2) onset of
symptoms after a single exposure incident or accident; (3)
exposure to a gas, smoke, fume, or vapor with irritant
properties present in very high concentrations; (4) onset
of symptoms within 24 h after the exposure, with