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Alergy tests for isofluorane anaesthetics


I work in Germany and anesthetize animals, rats and mice, with isoflurane (open mask method). I developed a shortness of breath, increasing from Monday to Friday, high transaminase levels and tachycardia events. It is getting worse over time. Last week I have been told that there are no allergy tests for isoflurane or trifluoroacetatic acid but found the paper on occupational asthma due to isofluorane. My questions: Do you know somebody who is able to do such a test?
Occupational Asthma, Specialist, 11/5/2014, 11/5/2014,

I think the first thing to do is for you to measure your peak expiratory flow 8 times daily for 3-4 weeks, making readings when you wake up, arriving at work, during each break at work, on leaving work, mid evening and bedtime, with readings at similar times on days away from work. You should record days when you are exposed to anaesthetic gasses, days when you are exposed to the animals without anaesthetics, and perhaps days when you have no animal exposure at all. Then analyse with the Oasys program downloadable from this website. It is only worth proceeding with specific challenges if you can demonstrate changes in PEF in relation to exposures at work. Rat and mouse allergens would be a more common cause for your asthma that isofluorane, so the ABC score from the Oasys plotter will give separate outcomes for each exposure. If the ABC score is >15 litres/min/hour with animal exposure and without anaesthetics, the animals are the more likely cause of your asthma and IgE assays are available (check that they are urinary antigens rather than hair). If the PEF changes are only when exposed to isofluorane, this becomes the most likely cause for your asthma.
I have a list of allergy centres in Germany (from 2012) who do specific challenge tests

Munich; Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Ludwig-Maximilians-Universität Munich

Bochum; Institut für Prävention und Arbeitsmedizin der DGUV (IPA), Ruhr-Universität Bochum

Hamburg; Institute for Occupational Maritime Medicine, University Medical Center Hamburg-Eppendorf

Bad Salzuflen; the Institut für Asthma- und Allergieklinik, arbeits- und sozialmedizinische Allergiediagnostik, Bad Salzuflen

Bad Lippspringe; Dr. med. Horst Müsken, Bad Lippspringe, Schwerpunktpraxis für Allergologie und Pneumologie/Institut für pneumologische und allergologische Begutachtung
Abstract Available for Do long periods off work in peak expiratory flow monitoring improve the sensitivity of occupational asthma diagnosis? Moore VC, Jaakkola MS, Burge CBSG, Pantin CFA, Robertson AS, Burge PS, Do long periods off work in peak expiratory flow monitoring improve the sensitivity of occupational asthma diagnosis?, Occup Environ Med, 2010;67:562-567,
Sherwood Burge, Oasys, an author of 'Do long periods off work in peak expiratory flow monitoring improve the sensitivity of occupational asthma diagnosis?' Charles Pantin, Keele, UK, an author of 'Do long periods off work in peak expiratory flow monitoring improve the sensitivity of occupational asthma diagnosis?' Vicky Moore, Oasys, an author of 'Do long periods off work in peak expiratory flow monitoring improve the sensitivity of occupational asthma diagnosis?' Cedd Burge, Oasys, an author of 'Do long periods off work in peak expiratory flow monitoring improve the sensitivity of occupational asthma diagnosis?' Alastair Robertson, Selly Oak Hospital, an author of 'Do long periods off work in peak expiratory flow monitoring improve the sensitivity of occupational asthma diagnosis?' Maritta Jaakkola, Oulu University Finland, an author of 'Do long periods off work in peak expiratory flow monitoring improve the sensitivity of occupational asthma diagnosis?'

Full Text Available for A New Diagnostic Score for Occupational Asthma Moore VC, Jaakkola MS, Burge CBSG, Robertson AS, Pantin CF, Vellore AD, Burge PS, A New Diagnostic Score for Occupational Asthma, Chest, 2009;135:307-314,
Sherwood Burge, Oasys, an author of 'A New Diagnostic Score for Occupational Asthma' Charles Pantin, Keele, UK, an author of 'A New Diagnostic Score for Occupational Asthma' Vicky Moore, Oasys, an author of 'A New Diagnostic Score for Occupational Asthma' Cedd Burge, Oasys, an author of 'A New Diagnostic Score for Occupational Asthma' Alastair Robertson, Selly Oak Hospital, an author of 'A New Diagnostic Score for Occupational Asthma' Arun Dev Vellore, Oasys, an author of 'A New Diagnostic Score for Occupational Asthma' Maritta Jaakkola, Oulu University Finland, an author of 'A New Diagnostic Score for Occupational Asthma'

Full Text Available for Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff 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, Allergy, 2006;61:1485-6,
Sherwood Burge, Oasys, an author of 'Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff' Vicki Drought, Oasys, an author of 'Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff' Vicky Moore, Oasys, an author of 'Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff' Alastair Robertson, Selly Oak Hospital, an author of 'Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff' Arun Dev Vellore, Oasys, an author of 'Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff' Bill Tunnicliffe, University Hospital Birmingham, an author of 'Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff'

Abstract Available for Exposure to dust and rat urinary aeroallergens in research establishments Nieuwenhuijsen MJ, Gordon S, Tee RD, Venables KM, McDonald JC, Newman Taylor AJ, Exposure to dust and rat urinary aeroallergens in research establishments, Occup Environ Med, 1994;51:593-596,
Tony Newman Taylor, Royal Brompton Hospital, London, an author of 'Exposure to dust and rat urinary aeroallergens in research establishments' Kate Venables, Oxford University, an author of 'Exposure to dust and rat urinary aeroallergens in research establishments' Rosemary Tee, Royal Brompton Hospital, an author of 'Exposure to dust and rat urinary aeroallergens in research establishments'

No Abstract Available for Respiratory allergy to urine proteins of rats and mice Newman Taylor AJ, Longbottom JL, Pepys J, Respiratory allergy to urine proteins of rats and mice, Lancet, 1977;ii:847-849,
Jack Pepys, Royal Brompton Hospital, an author of 'Respiratory allergy to urine proteins of rats and mice' Tony Newman Taylor, Royal Brompton Hospital, London, an author of 'Respiratory allergy to urine proteins of rats and mice' Joan Longbottom, Brompton Hospital, an author of 'Respiratory allergy to urine proteins of rats and mice'

11/5/2014

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