Answer to Question #1:
Yes, for the following reasons:
- most workers reported symptoms soon after exposure in the new facility;
- the dust levels were very high (> 10mg/m3);
- the pattern of symptoms are consistent with exposure to organic dust.
(Back to exercise)
Answer to Question #2:
Unlikely, for the following reasons:
- pattern of symptoms is not consistent with an allergy;
- no latency period present between exposure and symptoms (asthma, hypersensitivity pneumonitis).
(Back to exercise)
Answer to Question #3:
- Skin prick test (or specific IgE) to the seed pollen;
- Confirm asthma using serial PEFR and lung function spirometry.
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Answer to Question #4:
Organic dust toxic syndrome since symptoms occurred soon after exposure
This could be confirmed by:
- Measuring endotoxin levels in air;
- Culturing the grass seed to assess possible contamination (bacteria/fungi);
- Could do a nasal/bronchoalveolar lavage on the patient (look for predominantly neutrophilic as opposed to eosinophilic inflammatory response).
(Back to exercise)
Answer to Question #5:
Decrease exposure to the dust exposure levels:
- Enclose the sieving machine;
- Check and fix the ventilation system;
- Change work practices (decrease exposure time);
- Use of respirators (interim measure).
(Back to exercise)
Postgraduate Diploma in Occupational Health (DOH) - Modules 3 – 5: Occupational Medicine & Toxicology by Prof Rodney Ehrlich & Prof Mohamed Jeebhay is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
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