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Workplace Challenge Tests in Workers Excluded from Work with Possible Occupational Asthma
PDPI Sulawesi Selatan & Utara, 28 Nov 2018 10:44:03


Introduction: We present 5 cases where workers had been removed from the workplace because of their asthma and were prevented from returning to normal duties without proof that work was not the cause.

Methods: All workers lacked prior physiological evidence of OA. Workplace challenge tests were carried out with either a control day in hospital or at home. A clinical scientist escorted the worker at their place of work on the second day. The challenge lasted up to 4 hours with the worker subjected to usual exposures. FEV1 measurements were then continued away from exposure until bed. Where possible, a non-specific bronchial provocation test was carried out before and after the workplace challenge.

Results: All 5 workplace challenge tests were negative. The negative tests led to a return to normal duties after reports were sent to the occupational health or employer with the worker's consent. Following return to work serial PEF records analysed by the Oasys software showed possible OA in 1 worker. Details are shown in Table 1.

Table 1.
Case number Agent Months off work FEV1 % pred Treatment PD20 pre/post challenge (unexposed/exposed)
1 MWF 8 87 ICS + LABA Neg/Neg
2 welding fume 7 77 ICS +LABA + LAMA ND/ND
3 isocyanates 5 109 ICS +LABA Neg/Neg
4 emulsion paint 7 102 Nil Neg/ND
5 floor tile adhesive 12 100 ICS Neg/Neg
  • ND=Not done

Conclusion: Workplace challenge tests not only provide a diagnosis of OA but can also be used to refute the workplace association with asthmatic symptoms and lead to a return to work with substantial cost savings. Workers should be monitored using serial PEF on return to work as the exposure time may have not been long enough to elicit a reaction.

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