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Showing posts with label Occupational asthma. Show all posts
Showing posts with label Occupational asthma. Show all posts

How to Diagnose Occupational asthma

To make a diagnosis Occupational asthma, please note a history of atopy, exposure assessment, immunology (molecular and cellular), photograph and physiology as hipereaktivitas lung bronchus, lung function series, the specific inhalation test is the gold standard.

The diagnosis of occupational asthma in principle is to connect the clinical symptoms of asthma in the working environment is therefore a need for a good history and appropriate investigations. Thorough history of what happened in the work environment is essential, such as: when to start work somewhere this time, what the job before at work today, what is done every day, the process of what happens in the workplace, the materials used in the production process and the data material. And that is not less important is the field review by the examiner (doctor) to better understand the field situation.

Occupational asthma Diagnosis, Occupational asthma Provocation test, suspected occupational asthma

In addition to the history of the workplace, which should also know is about the clinical happening. When the first occurrence of complaints, since these began to enter the place or what is known as the latent period. Latent period can be several weeks to several years, usually 1-2 year. Clinical tightness, coughing, wheezing may occur during work, after work (evening and night) or both. When the frequency of attacks more often / deteriorated during weekdays than weekends or holidays, it can be suspected asthma that arise related to the workplace.

Investigations Spirometry (FEV1 checks) before and after the shift. Said to be positive if FEV1 decreased by more than 5% between before and after work; on the normal variable is less than 3%. This examination by many experts doubt the sensitivity because one study only 20% of patients with asthma due to colophony which fell during the workshift FEV1nya; while the decline in FEV1 is also found in 10% of a group of people who are not asthmatic (control).

Another way is to measure FEV1 and FVC in workers (suspected occupational asthma) are excluded from the work environment and then measured again at work again. If the results show improvement over leaving the workplace and supported by improvements to the complaints, it can be inferred the existence of the relationship of clinical and workplace grievances.

PEFR: Examination of serial PEFR (peak expiratory flow rate) during weekdays and a few days off at home, an examination of occupational asthma is best. It said the positive response when the curve measurements during the holidays at home is better than during weekdays.

Provocation test

There are two kinds of checks:
  1. Namely non-specific bronchial provocation using histamine or methacholine. This examination is only proving the existence of bronchial hiperreaktif.
  2. Specific bronchial provocation with allergens is the suspected cause. This examination can be carried out when the best way of proving that the allergen is the cause of the workplace. The difficulty lies in determining the cause and reproduction when allergens are known.

Skin tests and serological tests
This examination can be done if the causative agent of its large molecular weight material as it will stimulate the immunological reactions (IgE).

Management of Occupational asthma

Tags : Occupational asthma DiagnosisOccupational asthma Provocation testsuspected occupational asthma

Management of Occupational asthma

To prevent the occurrence of occupational asthma is a medical examination prior to employment, use of protective equipment, monitoring air pollutants in the working environment is highly recommended. If occupational asthma has occurred, then transfer to the outside of the work environment is important. If for some reason can not be moved then it must be the prevention and monitoring of lung function decline.

Periodic evaluation of lung function in workers who already suffer from occupational asthma are needed to prevent disability. Clinical asthma will persist until a few years even though the worker has been out of work environment.



Medical treatment in patients with occupational asthma such as bronchial asthma in general:

  1. Theophylline, a bronchodilator and may suppress neutrophil chemotactic factor. Effectiveness of the two functions above depend on the serum levels of theophylline.
  2. Beta agonists, bronchodilators are the most good for the treatment of occupational asthma in comparison with cholinergic antagonists (ipratropium bromid).
  3. The combination of beta-agonists with ipratropium bromid improve lung function is better than just a beta agonist alone.
  4. Corticosteroids, from various studies is known to prevent the bronchoconstriction caused by bronchial provocation with allergens. It will also improve lung function, decrease exacerbations and airway hiperesponsivitas and will ultimately improve the quality of life.

Occupational asthma

Occupational asthma is a respiratory disease characterized by attacks of shortness of breath, wheezing and coughing, which is caused by a variety of materials encountered in the workplace.

These symptoms usually occur due to spasm of the muscles lining the airways, so that the airway becomes very narrow.

Cause
Many substances (allergens, the cause of the symptoms) in the workplace that can cause asthma due to work. The most common are protein molecules (wood dust, grain dust, animal dander, mold particles) or other chemicals (especially diisocyanate).
Exact figures of the incidence of asthma because of the work is unknown, but suspected of approximately 20-20% of asthma in industrialized countries was asthma because of the work.



The workers who are at high risk for suffering from asthma because of the work is;
  • Plastic workers
  • Metal worker
  • Firing workers
  • Mill worker
  • Workers grain
  • Laboratory workers
  • Woodworker
  • Workers at the pharmaceutical
  • Workers at the detergent factory.


Symptoms
Symptoms usually occur shortly after exposure to the allergen and is often reduced or disappear if the patient leaves his workplace.
Symptoms often get worse during the working day and improved on weekends or holidays.

Some patients experienced new symptoms within 12 hours after exposure to the allergen.

Symptoms include:
  • Shortness of breath
  • Asthma
  • Cough
  • Feel the tightness in the chest.
Diagnosis
In the history of the disease, patients usually experience a worsening of symptoms when exposed to certain allergens in the environment where she worked.
On examination with a stethoscope would hear a wheezing (asthma, wheezing).

Other tests are usually performed:

  • Pulmonary function tests
  • Measurement of peak expiratory flow rates before and after work
  • Chest radiograph
  • Calculate blood type
  • Bronchial provocation tests (to gauge reaction to the suspected allergen)
  • Blood tests to find specific antibodies.


Prevention
Industries that use substances that can cause asthma, must control dust and air, because to eliminate it is an impossible thing.

Workers with severe asthma, if possible, should change his occupation because of constant exposure will make asthma worse and are settled.

If the allergen / cause has been unknown, to prevent the occurrence of symptoms, patients should avoid the allergen.

How to Diagnose Occupational asthma
Management of Occupational asthma

Tags : Occupational asthma causeOccupational asthma symptomsOccupational asthma diagnoseOccupational asthma PreventionOccupational asthma Treatment,

Bronchial Asthma

Bronchial asthma is a disease of the lung inflammation in the airways resulting in airway hiperrespon to various stimuli that can cause constriction of the airways that can arise thorough so shortness of breath that is reversible either spontaneously or with therapy.

Etiology
  • Genetic factors
  • Environmental factors
  • Materials allergens
  • Respiratory tract infections (especially viruses)
  • Air pollution
  • Food Factor



Trigger factors
  • Allergens
  • Physical
  • Chemicals
  • Infection
  • Mechanical factors
  • Psychological factors
Pathogenesis
The entry of allergens into the airway will cause a reaction between the allergen with immunoglobulin E. The release of materials from mastosit mediators, which cause the inflammation in the bronchial mucosa and submucosa causing bronchial smooth muscle contraction.

Pathology
Infiltration of inflammatory cells such as eosinophils, neutrophils, and other airway epithelial damage, resulting in expenditures as well as mediators and thickening of the mucosal and submucosal edema. There is hyperplasia of the glands Goblet cells. Happen "mucous plug" on-line the airways.

Clinical Symptoms
Complaints and symptoms depend on the severity at the time of the attack. In bronchial asthma attacks are mild and without complications, complaints and no typical symptoms.

Complaints:
  • Breath sounds
  • Crowded
  • Cough

Physical examination
Abnormalities of the upper airway, bronchi, thoracic, and skins, can be rhinitis, sinusitis, bronchitis, asthma and alveoler broncho-lung hyperinflation.
General state:
  • Composmentis
  • Anxiety / anxiety / panic / sweating
  • Blood pressure increases
  • Pulse increased
  • Pulsus paradoxus: decrease in systolic blood pressure over 10 mm Hg at the time of inspiration
  • Respiratory frequency increased
  • Cyanosis
  • Auxiliary respiratory muscles hypertrophy
Lung:
  • Obtained prolonged expiratory
  • Wheezing
Laboratory:
  • Increased blood Eosinophils> 250/mm3
  • Analysis of blood gases in status asthmaticus
Radiology: there are no typical signs.
Pulmonary Physiology: decreased FEV1
Skin test: to indicate the presence of allergic
Bronchial provocation test: with inhaled histamine, acetylcholine, allergens.

Diagnosis
  1. Anamnesa: complaints of shortness of breath by breath sounds ngiik frequent recurrence. The existence of hereditary factors and the presence of precipitating factors.
  2. Physical examination: a thorough wheezing or prolonged expiratory phase.
  3. Laboratory:
• Sputum: Charcot-Leyden crystals, Spiral Curschmann
• Blood: increased number of eosinophils.
• Physiology lung: airway obstruction (ratio of FEV1 / FVC <75% or PEF <150 liters / minute)
• bronchial provocation tests, skin sensitivity test.
Differential Diagnosis
Complications
  • Respiratory infection
  • Atelectasis
  • Pneumothorax, Pneumomediastinum, Emphysema cutis
  • Respiratory failure
  • Arrhythmias (especially if previously existing cardiac abnormalities).

Management / Procedure of Bronchial asthma

Special Treatment of Bronchial Asthma


Tags : bronchial asthma symptoms, asthma symptoms, bronchitis asthma, acute bronchial asthma, bronchial asthma children, treatment of asthmachronic bronchial asthma, acute bronchial asthma, bronchial asthma pathophysiology, asthma bronchial definition, what is asthma

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