A Study of Characteristics of Michigan Welders With Breathing Problems Reported as Work-Related Asthma

Abstract

PURPOSE: To describe the characteristics of welders from Michigan with work related asthma (WRA). METHOD(S): The Division of Occupational & Environmental Medicine administers the State's surveillance program for occupational diseases. Reports of WRA received from physicians, hospitals and claims filed with Workers' Compensation are followed up with telephonic interview with the subject using a standardized questionnaire. Copies of pulmonary functions are requested. A final assessment regarding the diagnosis is then made based on the collected data. We reviewed the records of welders reported with WRA over the last 18 years (1990-2007;n=142;age 43.3+/-11.4years;M:F 94:48). Majority were deemed to have occupational asthma with unknown sensitizer (n=105,73.9%) followed by work aggravated asthma (n=18), occupational asthma with known sensitizer (n=13) and reactive airways dysfunction syndrome (n=6). RESULT(S): Number of reports per year over the last two decades was largely unchanged (7.9/year). Majority subjects were Caucasians (n=93,65.5%). Shortness of breath was the most common symptom (n=132, median duration:3 years, range<1-34 years) followed by wheezing (n=114, median duration:4 years, range<1-40 years), chest tightness (n=110, median duration:3 years, range<1-34 years) and cough (n=109, median duration:3 years, range<1-37 years). All subjects had atleast two of above four symptoms. Majority developed symptoms within the first year of exposure (n=77,54.2%;median duration:<1 year, range<1-22 years). Only half reported use of personal protective equipment (PPE)(n=71). Spirometry data was available for 106 respondents out of which 38 (35.8%) had predicted FEV1<80%. Reversibility, assessed among 54 subjects, was positive in nearly half (n=24; 44.4%). Methacholine challenge test, done in 24 subjects, was positive in 19 (79.2%). Most subjects had sought some medical treatment (95.8%), majority reported ER visits (n=86,60.6%) and several needed hospitalization (n=50,36.7%). CONCLUSION(S): The frequency of reported WRA has not changed over the last two decades. Majority subjects have chronic symptoms. Use of PPE remains low. Spirometry changes are common and many require ER visits and hospitalization. CLINICAL IMPLICATIONS: An increased awareness of WRA among welders is needed as WRA is associated with significant morbidity and healthcare costs. Avoidance of exposure must be promptly recommended for any subject with WRA symptoms.