Pre-employment NSBR unhelpful in predicting potroom asthma

This is a well preformed difficult study to achieve which investigated the predictive value of measuring pre-employment methacholine reactivity (NSBR) in a cohort of aluminium smelter workers, where there is a high risk of development of occupational asthma. It found that pre-employment NSBR did not predict asthma which developed in 28/278, or respiratory symptoms over the next 5 years. The rate of decline in FEV1 was non-significantly higher tin the NSBR group (-47.1 vs -42.4 ml/year), both greater than often found in unexposed younger populations. There is debate as to whether potroom asthma is due to the respiratory irritants present in potroom (predominately sulphur dioxide and hydrogen fluoride)), or to sensitisation to the aluminium fluoride. Whichever is the mechanism, this paper shows that lower exposures are needed to prevent new-onset asthma in exposed workers and that pre-employment measurement of NSBR does not contribute to worker selection.

References

	Abramson MJ, Gwini SM, de Klerk NH, Monaco AD, Dennekamp M, Fritschi L, Dimitriadis C, Mohebbi M, Musk AW, Sim MR, Predictive value of non-specific bronchial challenge testing for respiratory symptoms and lung function in aluminium smelter workers, Occup Environ Med, 2020;77:535-539,doi.org/10.1136/oemed-2019-106344

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