Sevoflurane and isoflurane cause occupational asthma in healthcare workers (new cause)

Agent
Isoflurane and sevofluorane; anaesthetic gasses

Job
Anaesthetic assistant and nurse mostly exposed in recovery areas

Proof
IgE not tested

Skin prick test to allergen extract not tested

Non specific bronchial reactivity developed post challenge in 3/3; normal before challenge 3/3

Serial peak flow records positive 1/3; equivocal 1/3; not done 1/3

Specific Bronchial Challenge: late reaction to isoflurane and sevoflurane 15 breaths 0.5% (1); late reaction isoflurane alone 18 breaths 0.5% (1); rash and nsbr decline isoflurane alone 18 breaths 0.5% (1); controls no reaction

Follow up
Better after relocation away from recovering post-op patients exhaling anaesthetic gasses. One had anaphylactic reaction during a general anaesthetic using sevoflurane

References

	Vellore AD, Drought VJ, Tunnicliffe B, Moore VC, Robertson AS, Burge PS, Occupational Asthma and allergy to sevoflurane and isoflurane in Anaesthetic staff, Eur Respir J Suppl, 2006;28:245s,

	Vellore AD, Drought VJ, Sherwood-Jones D, Tunnicliffe B, Moore VC, Robertson AS, Burge PS, Occupational asthma and allergy to sevoflurane and isoflurane in anaesthetic staff, Allergy, 2006;61:1485-6,

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