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Can serial PEF measurements separate occupational asthma from allergic alveolitis?
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Burge, P. S., Moore, V.C., Burge , C. B. S. G., Vellore, A. D., Robertson, A. S. and Robertson, Wendy (2015) Can serial PEF measurements separate occupational asthma from allergic alveolitis? Occupational Medicine, Volume 65 (Number 3). pp. 251-255. doi:10.1093/occmed/kqv013 ISSN 0962-7480.
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Official URL: http://dx.doi.org/10.1093/occmed/kqv013
Abstract
BACKGROUND:
Occupational asthma commonly results in work-related changes in serial peak expiratory flow (PEF) measurements. Whether alveolitis can result in similar changes is unknown.
AIMS:
To identify differences and similarities of serial PEF between workers with occupational alveolitis and asthma seen during an outbreak investigation in a factory with metal-working fluid exposure.
METHODS:
Workers with respiratory symptoms and rest-day improvement were identified by questionnaire. Each was asked to measure PEF 8 times daily for 4 weeks at home and work. Alveolitis was subsequently diagnosed from a validated scoring system including radiological changes, carbon monoxide diffusing capacity, bronchoalveolar lavage and biopsy results. Occupational asthma was confirmed with a positive Oasys score >2.5 and a mean rest-work PEF >16 l/min from serial 2-hourly PEF measurements. The Oasys PEF plotter calculated differences between rest and workdays for mean PEF, diurnal variation and the scores were used to confirm an occupational effect (Oasys, area between curve and time point). Records were compared between the alveolitis group and the group with occupational asthma without alveolitis.
RESULTS:
Forty workers with occupational asthma and 16 with alveolitis had indistinguishable PEF changes on workdays in terms of magnitude (median reduction 18.5 and 16.1 l/min, respectively) and diurnal variation. Immediate reactions were more common with occupational asthma and late reactions more common with alveolitis.
CONCLUSIONS:
PEF responses to metal-working fluid aerosols do not distinguish occupational asthma from alveolitis except in timing. They can be used to identify the workplace as the cause of asthma and also alveolitis.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > RC Internal medicine | ||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Statistics and Epidemiology Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Hypersensitivity pneumonitis -- Diagnosis , Metal-working lubricants, Lungs -- Effect of chemicals on, Asthma, Occupational diseases | ||||
Journal or Publication Title: | Occupational Medicine | ||||
Publisher: | Oxford University Press | ||||
ISSN: | 0962-7480 | ||||
Official Date: | April 2015 | ||||
Dates: |
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Volume: | Volume 65 | ||||
Number: | Number 3 | ||||
Page Range: | pp. 251-255 | ||||
DOI: | 10.1093/occmed/kqv013 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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