Ong T H, Tan K L, Lee H S, Eng P
Department of Respiratory and Critical Care Medicine, Singapore General Hospital.
Ann Acad Med Singap. 2004 Mar;33(2):275-8.
We report the first case of occupational asthma due to gluteraldehyde exposure in Singapore and also describe the use of a specific inhalational challenge (SIC) test in confirming the diagnosis.
A 32-year-old laboratory technician presented with adult-onset asthma 2 years after daily exposure to gluteraldehyde which was used to sterilise the mouthpieces used for lung function testing. SIC testing showed a 25% drop in FEV1 after exposure to gluteraldehyde but not after exposure to a control, thus confirming the diagnosis.
Alternative arrangements were made for sterilisation of the mouthpieces so that gluteraldehyde could be removed from the workplace. There was a marked improvement in her asthmatic control thereafter.
This case illustrates the use of a SIC test in the diagnosis of occupational asthma. Gluteraldehyde is a known cause of occupational asthma and should be kept in mind when evaluating asthmatic patients in at-risk occupations. Effective ventilation and proper storage should be ensured to minimise exposure to gluteraldehyde where its use is necessary.
我们报告了新加坡首例因接触戊二醛而导致职业性哮喘的病例，并描述了使用特异性吸入激发（SIC）试验来确诊的情况。
一名32岁的实验室技术员在每日接触用于对肺功能测试口件进行消毒的戊二醛两年后出现成人起病的哮喘。SIC试验显示，接触戊二醛后第一秒用力呼气容积（FEV1）下降了25%，而接触对照物后未下降，从而确诊。
对口件消毒采取了其他安排，以便从工作场所去除戊二醛。此后，她的哮喘控制情况有了显著改善。
该病例说明了SIC试验在职业性哮喘诊断中的应用。戊二醛是职业性哮喘的已知病因，在评估从事高危职业的哮喘患者时应予以考虑。在必须使用戊二醛的地方，应确保有效通风和妥善储存，以尽量减少接触。
