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Occupational Medicine Advance Access published online on June 15, 2009
Occupational Medicine, doi:10.1093/occmed/kqp083
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Peak expiratory flow analysis in workers exposed to detergent enzymes

Vicky C. Moore1, Paul Cullinan2, Steven Sadhra3 and P. Sherwood Burge1

1 Occupational Lung Disease Unit, Department of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK
2 Department of Occupational and Environmental Medicine, National Heart and Lung Institute, Imperial College, London, UK
3 Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK

Aims To study serial peak expiratory flow (PEF) responses in a group of symptomatic detergent enzyme-exposed workers.

Methods Workers were recruited from a biological detergent formulating and packaging company. Those with occupational asthma symptoms and/or specific IgE to a detergent enzyme were asked to complete 2 hourly PEF measurements for 4 weeks. Outputs from the Oasys program (Oasys score, rest–work score and rest–work difference in diurnal variation) assessed PEF response. These were then related to the levels of sensitization and current occupational exposure to detergent enzymes.

Results In all, 67/72 workers returned PEF records; 97% were able to return a record with at least four readings per day and 87% at least 3 weeks in length. Of total, 79% (n = 27) of those with a final diagnosis of occupational asthma had peak flow records confirming the disease using Oasys. PEF response was similar in those with high, medium and low levels of exposures and those with negative, low–moderate and high specific IgE levels.

Conclusions The Oasys program is a sensitive tool for the diagnosis of detergent enzyme occupational asthma, but the levels of exposure and specific IgE sensitization to enzymes do not affect the magnitude of PEF response in symptomatic workers.

Keywords      Detergent enzymes; Oasys; occupational asthma; peak expiratory flow

Correspondence to: Vicky C. Moore, Occupational Lung Disease Unit, Department of Respiratory Medicine, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK. Tel: +44 121 424 2745; fax: +44 121 772 0292; e-mail: vicky.c.moore{at}heartofengland.nhs.uk


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