Occupational Asthma Reference
Vellore AD, Drought VJ, Sherwood-Jones D, Tunnicliffe B, Moore VC, Robertson AS, Burge PS,
Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff,
Keywords: anaesthetic, health care, asthma, challenge, peak flow, isoflurane, sevoflurane, angiooedema, dermatitis
Isoflurane has caused contact dermatitis in an anaesthetist (1), and dermatitis is common in anaesthetic workers (2). However, there are no prior reports of occupational asthma. We report three cases with occupational asthma, work-related angioedema or dermatitis to isoflurane (1-chloro-2,2,2-
trifluoroethyl difluoromethyl ether) and sevoflurane [fluoromethyl 2,2,2-trifluoro- 1-(trifluoromethyl) ethyl ether] with positive specific bronchial provocation testing. All worked as anaesthetic assistants or nurses in the same hospital.
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Isoflurane and sevofluorane; anaesthetic gasses
Anaesthetic assistant and nurse mostly exposed in recovery areas
IgE not tested
Skin prick test to allergen extract not tested
Non specific bronchial reactivity developed post challenge in 3/3; normal before challenge 3/3
Serial peak flow records positive 1/3; equivocal 1/3; not done 1/3
Specific Bronchial Challenge: late reaction to isoflurane and sevoflurane 15 breaths 0.5% (1); late reaction isoflurane alone 18 breaths 0.5% (1); rash and nsbr decline isoflurane alone 18 breaths 0.5% (1); controls no reaction
Better after relocation away from recovering post-op patients exhaling anaesthetic gasses. One had anaphylactic reaction during a general anaesthetic using sevoflurane
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