This month's issue focuses on a form of work-related asthma known as RADS which may develop after an acute over-exposure to an irritating vapor, fume, smoke or dust. Two recently reported cases of RADS are presented followed by a description of this form of asthma. Approximately ten percent of the WRA cases interviewed by Massachusetts SENSOR are classified as RADS. While the prevention of other forms of work-related asthma focus on limiting exposure to known asthma-causing agents, RADS prevention efforts require attention to spill prevention and safe handling procedures of a broader range of chemicals. Case 1 - This case involves a forty-one year old plumber who had been working for six years installing HVAC equipment. He frequently worked with insulation in dusty areas. One day, he was spraying conductor coils with sodium hydroxide when the wind shifted and he inhaled a large, concentrated amount of the sodium hydroxide. Within twenty-four hours of this exposure, he experienced wheezing, coughing, chest tightness, and shortness of breath. Case 2 - This case involves a twenty-six year old male who worked as a utility operator for a cereal manufacturer. One day, he was operating a forklift in the grain room when a storage hopper was emptied for repair. Several hundred pounds of oat flour were dumped on the floor to enable maintenance workers to replace a part. While the maintenance workers wore respirators, the patient who was not involved in the repair, did not. He experienced difficulty breathing and began coughing immediately and was treated in the emergency room. Massachusetts is one of four states that conduct surveillance of work-related asthma; the others are California, New Jersey, and Michigan. Between 1993-1995, 123 cases of RADS were identified in these four states. The RADS cases were more likely to be employed in technical, sales, and administrative occupations and less likely to be employed as operators, fabricators, or laborers. Eighty-nine percent of the RADS cases reported that they still had breathing problems at the time of the interview (at least three months after the exposure) and 79% reported that they had been treated in the emergency room for breathing problems. Forty percent of RADS cases were hospitalized for work-related breathing problems whereas 28% of cases with new-onset work-related asthma due to a known sensitzers were hospitalized.
Occupational-diseases; Occupational-health; Lung-disease; Work-environment; Workers; Occupational-exposure; Respiratory-system-disorders; Pulmonary-system-disorders; Bronchial-asthma; Employee-exposure; Occupational-respiratory-disease; Health-care; Disease-prevention; Airway-resistance; Surveillance-programs; Medical-monitoring; Lung-irritants; Case-studies; Vapors; Fumes; Dusts; Airborne-particles; Safety-measures; Accident-prevention; Materials-handling; Sodium-compounds; Grain-dusts
Massachusetts Department of Public Health, Occupational Health Surveillance Program, 250 Washington Street, 6th Floor, Boston, MA 02108