Burge S, Moore V, Burge C, Robertson A, Huntley C, Walters G
Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK.
Occup Med (Lond). 2022 Dec 7;72(8):541-549. doi: 10.1093/occmed/kqac087.
Work-related asthma symptoms are common in teachers and teaching assistants, there are few studies evaluating their causes.
To identify causes of occupational asthma in teachers and teaching assistants referred to the Birmingham Occupational Lung Disease clinic 2000-20 using evaluation of serial Peak Expiratory Flow (PEF) records.
Teachers and teaching assistants with possible occupational asthma were asked to record PEF 2-hourly at home and work for 4 weeks. Their records were evaluated with the Oasys programme. Those with a positive score for any of the three scores (area between curves (ABC), timepoint and Oasys score from discriminant analysis) were included. Repeat records were made as indicated to help identify the cause and the effects of remedial actions.
Thirty-eight teachers or teaching assistants met the inclusion criteria with all three Oasys scores positive in 24, 2/3 scores in nine and 1/3 in five. The building was the likely cause in 17 (in new builds particularly acrylates from carpet adhesives and in old buildings mould and construction dust), bystander exposure to agents in the schools in 12 (cleaning agents, acrylates from photocopiers and chloramines from indoor pools) and materials used in the classroom in 9 (most commonly MDF in design and technology classes). We illustrate how the PEF records helped identify the cause.
Oasys analysis of PEF records is a useful method of evaluating occupational asthma in teachers and identified difficult to confirm causes where successful remediation or redeployment was achieved.
与工作相关的哮喘症状在教师和教学助理中很常见，但评估其病因的研究较少。
通过对连续呼气峰值流速（PEF）记录的评估，确定2000 - 20年转诊至伯明翰职业性肺病诊所的教师和教学助理职业性哮喘的病因。
要求可能患有职业性哮喘的教师和教学助理在家和工作时每2小时记录一次PEF，持续4周。他们的记录用Oasys程序进行评估。三个评分（曲线间面积（ABC）、时间点以及判别分析得出的Oasys评分）中任何一个呈阳性的纳入研究。根据指示进行重复记录，以帮助确定病因和补救措施的效果。
38名教师或教学助理符合纳入标准，24人三项Oasys评分均为阳性，9人两项评分阳性，5人一项评分阳性。17例中建筑可能是病因（新建建筑中尤其地毯粘合剂中的丙烯酸酯，旧建筑中的霉菌和建筑灰尘），12例是在学校中接触旁观者接触的物质（清洁剂、复印机中的丙烯酸酯和室内游泳池中的氯胺），9例是教室中使用的材料（设计和技术课程中最常见的中密度纤维板）。我们举例说明了PEF记录如何有助于确定病因。
对PEF记录进行Oasys分析是评估教师职业性哮喘的一种有用方法，并能确定难以确诊的病因，在此基础上可成功实现补救或重新调配工作。
