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This lady has occupational asthma due to benzalkonium chloride which is common in cleaning agents. The solution is to replace the cleaning materials with ones that don't contain benzalkonium chloride and preferably don't contain biocides at all. After relocation the peak flow stabilises considerably but continues to be low and show some signs of occupational asthma. We think that benzalkonium chloride is still present in smaller quantities. This could be from other, as yet unidentified, cleaning products or by contamination from other areas of the supermarket.

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