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Work-related asthma in the emergency department.

Pechter-E; Nuernberg-A
SENSOR Occup Lung Dis Bull 2005 Sep; :1-2
This issue of the Occupational Lung Disease Bulletin focuses on work-related asthma (WRA) in the emergency department (ED). It was written by Dr. Amy Nuernberg, a fellow in occupational and environmental medicine at Harvard School of Public Health on rotation at the Occupational Health Surveillance Program. Individuals who have WRA often seek care in the ED. Among confirmed cases of WRA reported to MA SENSOR, 50% reported having sought treatment in the ED at least once. Recent MA survey findings suggest that individuals with WRA are much more likely to report treatment in an ED than individuals with asthma unrelated to work. In 2002, the Massachusetts Division of Health Care Finance and Policy established a statewide database of all ED visits. OHSP is now using this database to identify possible cases of WRA in an effort to broaden identification of sentinel cases beyond usual WRA reporters. Using data from the first two years, OHSP identified 343 ED visits in which the patient had a diagnosis of asthma or asthma symptoms associated with work, or reactive airways dysfunction syndrome (RADS). Each medical record was then reviewed, and the likely WRA cases were selected. Follow-up for case confirmation is ongoing, as is analysis of subsequent years of ED data. OHSP continues to rely on reporting from occupational medicine, primary care, and pulmonary practitioners for identification of sentinel cases. Remember to report suspected and confirmed cases of WRA to OHSP by phone, fax or mail. Case 1- A 37-year-old female smoker presents to an emergency department (ED) for worsening productive cough, shortness of breath, chest tightness and nasal burning. She has worked for one year at a small, family-owned business that makes cedar and oak chairs. She does inventory work at a desk in the warehouse where the chairs are cut, sanded, and assembled. Case 2 - A 48-year-old male nonsmoker presents to an ED by ambulance for acute shortness of breath and chest tightness. He inadvertently mixed bleach and hydrochloric acid while cleaning a bathroom in his job as custodian at a country club.
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; Case-studies; Physicians; Medical-services; Emergency-care; Airway-resistance; Smoking; Cigarette-smoking; Chlorine-compounds; Cleaning-compounds; Acids; Warehousing; Wood; Wood-dusts; Woodworking; Emergency-treatment; Household-bleach; Chemical-cleaning; Housekeeping-personnel; Housekeeping-products
Massachusetts Department of Public Health, Occupational Health Surveillance Program, 250 Washington Street, 6th Floor, Boston, MA 02108
7782-50-5; 7647-01-0
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SENSOR Occupational Lung Disease Bulletin
Performing Organization
Massachusetts State Department of Public Health