Occupational Health : Respiratory Surveillance

About 1500 to 3000 employees each year develop occupational asthma through being exposed to items at work. This is estimated to cost up to £10 million to the economy each year. Main areas where employees are likely to develop occupational asthma include bakers and food producers, beauty services, cleaning services, healthcare services, painters, repairers (including electronics), welders and woodworkers.

The chemicals which have the potential to cause occupational asthma includes isocyanates, floor dust, grain dust, glutaraldehyde, wood dust, rosin-cored solder fumes, latex, laboratory animals or glues and resins.

If the employee’s symptoms are detected early enough then it is possible to reduce the risk of that individual developing occupational asthma.

This surveillance is required by the Control of Substances Hazardous to Health Regulations 2002 for all employees who are exposed to these substances.

Employees are asked to undertake this test as the employer has identified that he/she may come into contact at work with chemicals which can very rarely cause occupational asthma.  This test will help to detect early onset of this condition.

What to Do Prior To the Test
Wear loose clothing.

What Not To Do Prior To the Test

• Do not undertake exercise 30 minutes prior to undertaking test
• Do not smoke 24 hours prior to undertaking the test
• Do not eat 1 hour prior to undertaking the test
• Do not use an inhaler 4 hours prior to undertaking the test

When employee attends for this testing, they will be required to complete a Respiratory Questionnaire and have a baseline lung function test which comprises:  

1. Individual will be clearly instructed by the Occupational Health Nurse in the procedure before the start of the test. The nurse will demonstrate what is required from the individual and allow them a ‘practice blow’ in order to ensure that maximum effort is gained.

2. The first test for Lung Vital Capacity (VC) will measure how much air can be expelled from the lungs. The individual will be requested to:-

• Breathe in and out normally, to take in a deep breath and fill lungs completely breathing in through the nose.
• Place the mouthpiece, connected to tubing from the spirometer, and then breathe out through the mouthpiece into the spirometer as much and completely as possible.

In order to ensure that the individual expires total air volume from the lungs, the nurse will encourage the individual to maximise their effort and may therefore request more than one expiration.

The Spirometer will automatically record the results of the test.

3. The second test will be to measure the Lungs Forced Vital Capacity (FVC); therefore, the individual will be requested to:

• Breathe in and out normally, and then take a deep breath, much deeper than the previous blows
• Place the mouthpiece into the mouth, closing their lips around the mouthpiece in order to make a complete seal.
• Then, blow as hard and fast as they possibly can.

Again, the individual will be encouraged by the nurse to give maximum effort and may request more than one ‘blow’.

The Spirometer will automatically record the results of the test.

Following the Test
Each test which takes approximately 20 minutes and the results are reviewed by an Occupational Health Nurse / Physician.  Following completion of a consent form, both the employee and employer are subsequently advised if the results are within the expected range.  If any problems are identified, then the employee will be asked to repeat the test and may be asked to see an Occupational Health Physician for further management of the condition.

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