Abstract

Asthma and rhinitis in boiler operators
AS ROBERTSON, PS BURGE Institute of Occupational Health, University of Birmingham, and East Birmingham Hospital, Birmingham Four boiler operators and one boiler chemist (mean age 47-4, range 35-54 y) from a Birmingham engineering company were referred to outpatients with work related symptoms. All workers complained of acute and chronic respiratory and nasal symptoms. Respiratory symptoms consisted of chest tightness, wheeze, cough and breathlessness and nasal symptoms including blocked or runny nose with pain, crusting and bleeding. Their job with the engineering company involved operating and occasionally cleaning oil, coal and gas fired boilers; four were still employed, one having left one year previously. They had been employed for a mean of 10-6 (range 5-19) years. All had previously been well while working as boiler operators elsewhere (mean 13-8 y). In November 1984 4/5 of the workers entered the boiler house after the oil fired boilers had been cleaned by contractors. All were systematically unwell in association with symptoms of asthma and profound nasal irritation that lasted approximately one week. Subsequent to this exposure all workers had variable work related nasal and respiratory symptoms. One worker gave a past history of pneumonia related to boiler cleaning. On examination three had inflamed nasal mucosae and one had a nasal perforation. The mean lung function of those currently working was reduced (% predicted): FEV, 75% (SD 18%), FVC 88% (SD 11%). Chest radiographs were normal in all five. Only one had a positive skin prick test response to a common allergen. Serial peak flow recordings in those engaged in routine boiler operations showed occupational asthma in one, small consistent declines in mean peak flow in two, and a normal record in the remaining worker. Although the acute irritant effects of the vanadium contained within oil fired boiler dust is well recognised, the recurrent nasal and respiratory symptoms associated with low level exposure described here have not previously been described.

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