Medical surveillance for prevention of occupational asthma

Szram, Joanna; Cullinan, Paul

doi:10.1097/aci.0b013e32835e1212

Cited by 20 publications

(7 citation statements)

References 28 publications

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“…However, obstructive abnormalities can be difficult to detect during occupational screening because asthma-related obstruction may vary. The spirometric results of most participants (even those with asthma) fall within normal limits, 48 so workers with borderline obstruction should undergo second-level tests, especially those working in specific environmental conditions. 29 We therefore looked for an early marker of alterations suggesting airway inflammation.…”

Section: Discussionmentioning

confidence: 99%

Work-related allergies to storage mites in Parma (Italy) ham workers

et al. 2015

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ObjectivesTo investigate the role of storage mites in the development of allergic diseases among ham production workers, and to search for early alterations in lung function tests and early inflammation markers in exhaled air. Respiratory allergies due to storage mites have been reported in people with various occupations but, although such mites are unavoidable when curing ham, there are no published data concerning ham production workers.SettingSecondary care.DesignExperimental cross-sectional study.Participants220 participants (110 ham production workers and 110 controls) were recruited.Primary and secondary outcome measuresWorkers answered a medical questionnaire, and underwent spirometry and fraction of exhaled nitric oxide at 50 mL/s (FeNO50) measurements. Those with allergic symptoms also underwent skin prick tests to determine their sensitisation to airborne allergens. A methacholine test was performed in symptomatic participants when spirometry was normal to assess airways hyper-responsiveness.ResultsSymptomatic storage mite sensitisation was observed in 16 workers (14.5%) (rhinoconjunctivitis in 15 (63%) and asthma in (4%)) and 2 controls (1.8%; p=0.001). Higher FeNO50 values in exposed symptomatic workers compared with healthy control participants (34.65±7.49 vs 13.29±4.29 ppb; p<0.001) suggested bronchial and nasal involvement, although their lung function parameters were normal. Regardless of exposure, a FeNO50 value of 22.5 ppb seems to be 100% sensitive and 99.4% specific in distinguishing allergic and non-allergic participants. Multivariate analysis of FeNO50 values in the symptomatic participants showed that they were positively influenced by IgE-mediated allergy (p=0.001) and reported symptom severity (p=0.041), and negatively by smoking status (p=0.049).ConclusionsHam processing workers, as well as workers involved in any meat processing work that includes curing, should be informed about the occupational risk of sensitisation to mites.

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Section: Discussionmentioning

confidence: 99%

Work-related allergies to storage mites in Parma (Italy) ham workers

et al. 2015

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“…Szram and Cullinan [39] suggested that workers with occupational asthma may make a conscious decision about whether having a job is worth tolerating having occupational asthma. However, there was no formal behavioral economic analysis of the trade-off between income and asthma.…”

Section: General or Disease-specific Instrumentsmentioning

confidence: 99%

Respiratory disability and impairment

Harber

2015

Current Opinion in Pulmonary Medicine

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“…Such pre-placement spirometry may also provide information to determine whether the worker should be advised to avoid such placement in jobs that may carry risk of work-related asthma from exposure to respiratory irritants or sensitizers [8 && ]. For those who do work in such environments, medical surveillance with serial assessment of spirometry, respiratory questionnaires and in some circumstances, immunologic testing and/or chest imaging is often performed with the aim of early detection of respiratory disease, as recently reviewed [7,9].…”

Section: Use Of Spirometry As Part Of a Medical Surveillance Programmentioning

confidence: 99%