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Deadly consequences of undiagnosed work-related asthma (WRA): Michigan case study.

Authors
Massachusetts Department of Public Health Occupational Health Surveillance Program
Source
SENSOR Occup Lung Dis Bull 2007 Apr; :1-2
NIOSHTIC No.
20042650
Abstract
In 2005, a 50 year-old male suffered an asthma attack and collapsed at the adhesive manufacturer where he worked. EMS arrived at the scene within five minutes but were unable to revive him. He never regained consciousness and died at the hospital six days later. He had no family history of allergies and no asthma symptoms prior to beginning this job. He was a smoker. A review of his medical care revealed that he had 18 visits to health care providers regarding his asthma but had not received a diagnosis of occupational asthma or a medical recommendation to leave the job, despite his requests. His initial doctor visits began in January 2002, one month after he began working. He had four company medical screenings with a physician who documented decreasing FEV1 levels over a three-year period, from 95% predicted to 73% predicted. However, this physician failed to note any problems or recommend change of work. The victim visited the emergency department five times and notes in his chart documented possible COPD or acute bronchitis and exposure to glue fumes at work. The victim had seven visits with his primary care physician, who documented poorly controlled asthma triggered by chemicals at work. The patient expressed a desire to leave his job and asked if there were any medical reasons to support this decision, but the physician did not diagnose WRA or urge job modification, instead referring him to a pulmonologist. Following medical advice, the victim visited a pulmonologist twice, who noted in the chart that the patient was exposed to isocyanates [known asthmagens] and wrote that the patient had "reactive airways disease which is likely occupationally-related, though I do stop short at this time of calling it occupational asthma." The pulmonologist recommended a clinical reevaluation and spirometry two months later. The patient died before he could return for this appointment.
Keywords
Occupational-diseases; Occupational-health; Lung-disease; Work-environment; Occupational-exposure; Respiratory-system-disorders; Pulmonary-system-disorders; Bronchial-asthma; Employee-exposure; Occupational-respiratory-disease; Health-care; Surveillance-programs; Lung-irritants; Mortality-data; Case-studies; Chemical-factory-workers; Smoking; Cigarette-smoking; Physicians; Medical-services; Emergency-care; Glue-manufacturing; Adhesives; Fumes; Decision-making; Isocyanates; Airway-resistance
Contact
Massachusetts Department of Public Health, Occupational Health Surveillance Program, 250 Washington Street, 6th Floor, Boston, MA 02108
Publication Date
20070401
Document Type
Other
Funding Type
Cooperative Agreement
Fiscal Year
2007
NTIS Accession No.
NTIS Price
Identifying No.
Cooperative-Agreement-Number-U60-OH-008490
Priority Area
Healthcare and Social Assistance
Source Name
SENSOR Occupational Lung Disease Bulletin
State
MA
Performing Organization
Massachusetts State Department of Public Health
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