Monitoring of Peak Expiratory Flow Rates in Cork Workers' Occupational Asthma

Abstract

Suberosis is an occupational lung disorder of cork industry workers usually presenting as an extrinsic allergic alveolitis, but airway involvement in some cases makes the diagnostic approach complex. We assessed peak expiratory flow rates (PEF) in 17 cork workers with asthma symptoms that worsened at work, comparing three methods of PEF graph analysis. Complete agreement (three observers) was found in 12 of 17 cases (70.6%) with the visual inspection of mean daily values and in 11 of 17 cases (64.7%) with the minimum, maximum, and mean daily values (without any consensus in two cases). According to the mean PEF graph, there were eight positive readings (47%), five negative readings (29%), and four dubious readings (24%); with the other graphic analysis, two of the dubious cases were reclassified as negative. When we analyzed daily variability >20%, we found only three positive results, one of which was in absolute disagreement with the visual analysis. Our results suggest that it is possible to demonstrate occupational asthma in cork work exposure. The visual inspection of PEF monitoring shows a greater number of positive results than the index of daily variability; however, the latter may help to sort out dubious cases.

Cork workers? occupational asthma: lack of association with allergic sensitisation to fungi of the work environment

“…Traditionally, as in other occupational settings such as those of bird fanciers and farmers, this exposure leads to the development of hypersensitivity pneumonitis. However, description of cases of asthma in these settings is now more common, and its aetiology needs some clarification (Arlian et al 1997;Colloff et al 1997;Winck et al 2001;Hirakata et al 2002). In the absence of an identifiable aetiological agent, the assessment of peak expiratory flow rates, at and away from work, is a valuable diagnostic method to ascertain the occupational nature of a worker's asthma (Winck et al 2001).…”

“…However, description of cases of asthma in these settings is now more common, and its aetiology needs some clarification (Arlian et al 1997;Colloff et al 1997;Winck et al 2001;Hirakata et al 2002). In the absence of an identifiable aetiological agent, the assessment of peak expiratory flow rates, at and away from work, is a valuable diagnostic method to ascertain the occupational nature of a worker's asthma (Winck et al 2001). Accordingly, we have shown that the visual analysis of the mean, maximum, and minimum daily PEF values may be the procedure of choice to support the occupational nature of asthma in the cork industry.…”

“…Patients with occupational exposure performed serial peak expiratory flow (PEF) measurements as previously described (Winck et al 2001). They were asked to measure PEF every 2 h and to record the best of three attempts during at least 10 days at work and 10 days away from work, in a consecutive fashion.…”

“…We previously identified cases of occupational asthma in the cork industry, confirmed with serial peak expiratory flow recordings (Winck et al 2001), but its aetiology is still unknown. Apart from Penicillium glabrum, a fungus that induces immunological sensitisation in cork workers (Pimentel and Á vila 1973), Chrysonilia sitophila, another prominent fungus that colonises cork (Danesh et al 1997), has also been identified as a cause of occupational asthma in the wood industry (Cote et al 1991;Tarlo et al 1996).…”

Effect of 1,6-Hexamethylene Diisocyanate Exposure on Peak Flowmetry in Automobile Paint Shop Workers in Iran

“…A study by Wink et al (22) showed that mean peak fl ow in workers decreased on the day of exposure and increased on days when the workers were away from work. In our study, the mean peak fl ow at the end of the shift on the day of painting was signifi cantly lower than at the start of the shift, which may be related to HDI exposure.…”