Asthma and woodwork investigations
I have an employee who makes models mainly from soft wood, and fibreboard. After 25 years or so he recently presented with minor upper respiratory symptoms so we asked for serial peak flows and used OASYS to plot the results. These show a convincing work related drop in peak flows with recovery at weekends and holidays.
Dust from his work seems the likely explanation but there are period vehcle movements (DEE) and other tasks not too far away (mild steel weld some minimal use of solvents and adhesives).
I am reasonably convinced he has early Occ Asthma-
My question is that if I wanted to prove it was wood dust rather than other causes is there a way to do this? Such clarification may help with his redeployment.
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The only real way to find the specific cause is through specific inhalation challenge testing. This is done in specialist centres where the worker is admitted as an inpatient for a week and exposed to one agent each day while breathing tests are performed throught 12 hours. The worker would therefore need a referral to one of these centres for this to be carried out. If this isn't possible, relocation with further serial peak flow measurments would assess whether the relocation had been successful or not.
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That's what I thought, so I am going down the second of those two routes but just wondered if there was another panacea such as wood specific RAST. I do not think, and more importantly neither does the patient, that challenge testing is justified in his case.
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IgE does not really work for woods. The Oasys plot docoments occupational asthma, not the precice cause. You could trying relocating your patient away from the wood dust and repeat the pef record.
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