Occupational Asthma Reference

Feary J, Cannon J, Cullinan P, Breathing pattern disorder masquerading as occupational asthma, Eur Respir J, 2020;56 Suppl 6:652,10.1183/13993003.congress-2020.652

Keywords: case report, ILO, larngeal obstruction, Oasys, laryngoscopy

Known Authors

Paul Cullinan, Royal Brompton Hospital, London, UK Paul Cullinan

Julie Cannon, Royal Brompton Hospital London Julie Cannon

Jo Feary, Royal Brompton Hospital Jo Feary

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Abstract

Background:
Serial peak flow monitoring is commonly used to diagnose occupational asthma (OA).

Methods:
A laboratory animal (LA) worker presented with work-related dyspnoea triggered by talking, dust and modest exertion. It was also present, to a lesser extent, away from work. She recorded her peak flow (PF) =4 times a day on consecutive days for 4 weeks. The values were plotted using specialist software.

Results:
Spirometry was normal (FEV1 2.98 (105%) and FVC 3.41 (106%)). PF plot showed striking work-related variability (fig 1); OASYS score was 3.91 and ABC score was 95 indicating >90% probability of OA. Serum specific IgE and skin prick tests to LA allergens were negative. There was no exposure to other respiratory sensitisers. Respiratory physiotherapy assessment identified breathing pattern disorder (Nijmegen Questionnaire score 46/64). We explained she did not have OA; her symptoms were managed with physiotherapy and she continued working in her existing role.

Plain text: Background: Serial peak flow monitoring is commonly used to diagnose occupational asthma (OA). Methods: A laboratory animal (LA) worker presented with work-related dyspnoea triggered by talking, dust and modest exertion. It was also present, to a lesser extent, away from work. She recorded her peak flow (PF) >=4 times a day on consecutive days for 4 weeks. The values were plotted using specialist software. Results: Spirometry was normal (FEV1 2.98 (105%) and FVC 3.41 (106%)). PF plot showed striking work-related variability (fig 1); OASYS score was 3.91 and ABC score was 95 indicating >90% probability of OA. Serum specific IgE and skin prick tests to LA allergens were negative. There was no exposure to other respiratory sensitisers. Respiratory physiotherapy assessment identified breathing pattern disorder (Nijmegen Questionnaire score 46/64). We explained she did not have OA; her symptoms were managed with physiotherapy and she continued working in her existing role.

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