Occupational Asthma Reference

Burge PS, O'Brien IM, Harries MG, Peak Flow Rate Records In The Diagnosis Of Occupational Asthma Due To Colophony, Thorax, 1979;34:308-316,

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Known Authors

Sherwood Burge, Oasys Sherwood Burge

Mark Harries, Brompton Hospital and Northwick Park Mark Harries

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Abstract

Peak expiratory flow (PEF) has been measured hourly from waking to sleeping in 29 workers with respiratory symptoms exposed to the fumes of soft soldering fluxes containing colophony (pine resin). Thirty-nine records of mean length 33 days have been analysed, and the results compared with the occupational history and bronchial provocation testing in the same workers. From plots of daily mean, maximum and minimum PEF, recurring physiological patterns of asthma emerge. The most common pattern is for asthma to increase with each successive working day. Some workers had equivalent deterioration each working day.

Regular recovery patterns taking one, two and three days are described. The combination of a three day recovery pattern and a late asthmatic reaction on Monday results in Monday being the best day each week. Assessment of these records has shown them to be specific and sensitive, provided that the worker was not taking corticosteroids or cromoglycate during the period of the record and that bronchodilator usage was kept constant on days at home and at work. The results of the PEF records correlate well with bronchial provocation testing, and provide a suitable alternative to this for the diagnosis of mild to moderate occupational asthma. The records are of particular use for screening symptomatic workers whose symptoms appear unlikely to be related to work.

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