Occupational Asthma Reference

Walters GI, Robertson AS, Moore VC, Burge PS, Occupational asthma caused by acrylic compounds from SHIELD surveillance (1989–2014), Occup Med, 2017;67:282-289,10.1093/occmed/kqx036
(Plain text: Walters GI, Robertson AS, Moore VC, Burge PS, Occupational asthma caused by acrylic compounds from SHIELD surveillance (1989-2014), Occup Med)

Keywords: OA, Shield, UK, teacher, acrylate, floor adhesive, ch, pef, Oasys, beauty, printing, prosthetic limb, orthopaedic nurse, anaesthetist, dentist,moulder ,

Known Authors

Sherwood Burge, Oasys Sherwood Burge

Vicky Moore, Oasys Vicky Moore

Alastair Robertson, Selly Oak Hospital Alastair Robertson

Gareth Walters, Heartlands Gareth Walters

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Abstract

Background
Acrylic monomers (acrylates), methacrylates and cyanoacrylates all cause asthma by respiratory sensitization. Occupational inhalation exposures occur across a variety of industries including health care and dental work, beauty, laboratory science, assembly and plastic moulding.

Aims
To examine notifications of occupational asthma caused by acrylic compounds from a UK-based regional surveillance scheme, in order to highlight prevalent exposures and trends in presentation.

Methods
Retrospective review of all cases reported to the SHIELD surveillance scheme for occupational asthma, West Midlands, UK between 1989 and 2014. Patient data were gathered on demographics, employment, asthma symptoms and diagnostic investigations including serum immunological testing, serial peak flow analysis and specific inhalation challenge tests. Descriptive statistics were used to illustrate worker characteristics and evidence for sensitization to acrylic compounds.

Results
There were 20 affected patients out of 1790 total cases of occupational asthma (1%); all cases were confirmed by OASYS (Occupational Asthma SYStem) analysis of serial peak flow measurements, with three additional positive specific inhalation challenge tests. Three out of 20 (15%) patients were current smokers and 11/20 (55%) were atopic. A variety of exposures and industries were implicated including: manufacturing, health care, beauty and printing and a novel presentation seen in teachers exposed to floor adhesives.

Conclusions
This is the largest reported series of occupational asthma caused by acrylic compounds, which remain an important aetiological factor in this disease. Exposure occurs in a variety of industries, particularly in manufacturing and is seen with other, perhaps better recognized sensitizing agents such as isocyanates and epoxy resins.

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Comments

This review of cases from the Shield database reported 20 cases of occupational asthma due to acrylates, 1% of total notifications 1989-2014. A tackifier used to stick carpet tiles down in a new school caused cases in teachers and an artificial limb maker was sensitised while making the prostheses. Other more usual cases occurred in orthopaedic theatre staff from beme cement, nail technicians and plastic moulders. One dentist was sensitised to tooth-filling acrylates.
6/26/2017

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