Occupational Asthma Reference

Suojalehto H, Karvala K, Haramo J, Korhonen M, Saarinen M, Lindström I, Medical surveillance for occupational asthma—how are cases detected?, Occup Med, 2017;67:159-162,doi.org/10.1093/occmed/kqw101
(Plain text: Suojalehto H, Karvala K, Haramo J, Korhonen M, Saarinen M, Lindstrom I, Medical surveillance for occupational asthma-how are cases detected?, Occup Med)

Keywords: Finland. surveillance, OA, rhinitis, FEV1

Known Authors

Hille Suojalehto, Finnish Institute of Occupational Health Hille Suojalehto

Irmeli Lindstrom, Finnish Institute of Occupational Health Irmeli Lindstrom

If you would like to become a known author and have your picture displayed along with your papers then please get in touch from the contact page. Known authors can choose to receive emails when their papers receive comments.

Abstract


H. Suojalehto; K. Karvala; J. Haramo; M. Korhonen; M. Saarinen ...
Abstract
Background
In Finland, medical surveillance, including spirometry, is periodically performed for workers who are exposed to agents capable of causing occupational asthma (OA). Although it has been shown that surveillance can detect OA at an early stage, few studies have assessed its benefits or the role of surveillance spirometry.
Aims
To assess the role of surveillance and spirometry in detecting OA and to evaluate the quality of spirometry.
Methods
We retrospectively reviewed the medical files of patients in health surveillance programmes who were diagnosed with sensitizer-induced OA at the Finnish Institute of Occupational Health in 2012?14. We collected information on work exposure, respiratory symptoms, healthcare visits that initiated the diagnostic process, first spirometry and other diagnostic tests.
Results
Sixty files were reviewed. Medical surveillance detected 11 cases (18%) and 49 cases (82%) were detected at doctors’ appointments that were not related to surveillance. The median delay from the onset of asthma symptoms to diagnosis was 2.2 years. Delay did not differ between these groups. No cases were detected on the basis of abnormal spirometry without respiratory symptoms. However, five patients (8%) initially reported solely work-related rhinitis symptoms. Spirometry was normal in half of the cases and quality criteria were fulfilled in 86% of the tests.
Conclusions
Fewer than one in five OA cases were detected through medical surveillance. Investigations were initiated by respiratory symptoms. No asymptomatic worker was referred because of abnormal spirometry. Our results highlight the importance of work-related nasal symptoms in detecting OA.

Plain text: H. Suojalehto; K. Karvala; J. Haramo; M. Korhonen; M. Saarinen ... Abstract Background In Finland, medical surveillance, including spirometry, is periodically performed for workers who are exposed to agents capable of causing occupational asthma (OA). Although it has been shown that surveillance can detect OA at an early stage, few studies have assessed its benefits or the role of surveillance spirometry. Aims To assess the role of surveillance and spirometry in detecting OA and to evaluate the quality of spirometry. Methods We retrospectively reviewed the medical files of patients in health surveillance programmes who were diagnosed with sensitizer-induced OA at the Finnish Institute of Occupational Health in 2012?14. We collected information on work exposure, respiratory symptoms, healthcare visits that initiated the diagnostic process, first spirometry and other diagnostic tests. Results Sixty files were reviewed. Medical surveillance detected 11 cases (18%) and 49 cases (82%) were detected at doctors' appointments that were not related to surveillance. The median delay from the onset of asthma symptoms to diagnosis was 2.2 years. Delay did not differ between these groups. No cases were detected on the basis of abnormal spirometry without respiratory symptoms. However, five patients (8%) initially reported solely work-related rhinitis symptoms. Spirometry was normal in half of the cases and quality criteria were fulfilled in 86% of the tests. Conclusions Fewer than one in five OA cases were detected through medical surveillance. Investigations were initiated by respiratory symptoms. No asymptomatic worker was referred because of abnormal spirometry. Our results highlight the importance of work-related nasal symptoms in detecting OA.

Full Text

Full text of this reference not available

Please Log In or Register to add the full text to this reference

Associated Questions

Registered users of this website have associated this reference with the following questions. This association is not a part of the BOHRF occupational asthma guidelines.

What is the benefit of surveillance for occupational asthma and how should it be achieved
burgeps At first glance this paper finds that surveillance only detect 11/60 new cases cases of occupational asthma in workers exposed to sensitising agents in Finland, and also states that no cases were detected by spirometry who were asymptomatic. However we are also told that the median time from first symptom to diagnosis was 2.1 years is those detected by surveillance and 2.2 years in those detected (?by their occupational health services) outside formal surveillance visits, and that spirometry was abnormal in 8/15 in whom it was performed at the time investigation was initiated. An alternative explanation would be that symptoms of asthma or rhinitis, or abnormal spirometry, identified at surveillance, did not trigger an evaluation for occupational asthma, or that surveillance was being carried out too infrequently (we have no information on this).

Please Log In or Register to put forward this reference as evidence to a question.

Comments

Please sign in or register to add your thoughts.


Oasys and occupational asthma smoke logo