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SOM ASM2006 ScottishSHIELD


SOM ASM2006 ScottishSHIELD

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									      Piloting a Surveillance Scheme for
      Occupational Airways Disease in Scotland:
    Ayres JG1, Scaife AR1, Semple S1, Henderson GD1,
    Burge PS2 and Scadding G3                                                                     Unknown
                                                                                                  Prawn Packer
    1. Environmental & Occupational Medicine, University of Aberdeen, Aberdeen                               Baker             1        Bronchitis
    2. Occupational Respiratory Medicine, Birmingham Heartlands Hospital,                                                       RADS +
       Birmingham                                                                 Baker                                        Bronchitis
                                                                                  Seafood Production Manager          2
    3. Royal National Throat Nose and Ear Hospital, London                                                                                                                   Chemist
                                                                                                                              RADS                                           Chicken Sexer (2)
                                                                                                                                                                             Dairy Farmer
                                                                                                 Nurse                                                                       Farm manager
                                                                                                                     1 OA +                                                  Laboratory Scientist (3)
                                                                                                                                                       OA                    Harbour Loader
    Background                                                                             Welder
                                                                                                                          OA + Rhinitis
                                                                                                                                                                      13     Paint Sprayer
                                                                                                                                                                             Quality Assurance Inspector
                                                                                           Knackery Worker                2                                                  Tiler
    Occupational asthma (OA) is common but much under-recognised. It is
    estimated that 1 in 10 of all cases in adult life is due to occupation.
    3,000 cases of OA are recognised each year in the UK1 leaving a large         Figure 1. Distribution of Diagnoses
    number of cases either permanently unrecognised or recognised late in
    the clinical course. Recognition of OA is important not only from the
    individual’s point of view but also by identifying particular places of       • 6 month follow-up questionnaires - 14 sent and returned to date
    work or specific occupations which can then be dealt with and further         • Of 10 in same employment
    cases prevented. A successful surveillance scheme for reporting OA                   - 7 in same job (6 issued with mask by employer, 1
    has been established and running for 12 years in the West Midlands-                    provided own mask and all wear mask as and when
    SHIELD.2,3                                                                             necessary)
                                                                                       -   1 off sick
                                                                                       -   2 doing different job
                                                                                  • 3- changed employment
    Aims                                                                          • 1- unemployed

    • To establish a surveillance scheme for occupational airways disease                           Chemist                                                        Harbour loader
      in Scotland                                                                                   Paint sprayer
                                                                                                    Road cleaner
    • To pilot a surveillance methodology in NE Scotland, including the                                                                              unemployed

      Inverness area and the Orkney and Shetland Islands,                                              Different
      respiratory and occupational physicians in the area based on                                                                                                             6 issued with mask by employer
                                                                                                                                                                               (chicken sexer, dairy farmer,
      SHIELD methodology used in the West Midlands –                                       Nursing Auxillary                                                                   farm manager, tiler,
      ScottishSHIELD.                                                                      Seafood Production             Same
                                                                                                                                                                               laboratory scientist,
                                                                                                                                                     Employed in               quality assurance inspector )
                                                                                                                      2 Different job
                                                                                                                                                     same job
                                                                                                                                                                               1 provided own mask
                                                                                                                                   Employed in
                                                                                                                                   same job                           7
    Methods                                                                                              Trawlerman
                                                                                                                                   Off sick

    • Patients with OA identified by reporting physicians
    • A questionnaire filled out (with patient consent) and sent centrally to
                                                                                  Figure 2. Results from 6 months follow-up questionnaire
      DEOM, Aberdeen via the internet
    • Data entered automatically from internet into an encrypted Access
    • A follow up questionnaire mailed to patients (with consent) after 6         Conclusion
                                                                                  • The Scottish SHIELD reporting system works but needs to be
                                                                                    used by more physicians to develop and overcome under-
    Results                                                                       • The system is now to be rolled out Scotland wide.

      • 21 cases reported to ScottishSHIELD
        (15 in the pilot period plus 6 additional cases since)
      • 16 (age range 28-58) had classical OA                                     References
        (2 males, a baker and a seafood production manager, also had
                                                                                  1. Hendrick DJ. The world wide problem of occupational asthma.
        Occupational Rhinitis and 1, a female nurse, also had RADS)
                                                                                     Clin Exper Allergy 2001; 31:1-4.
      • 2 had RADS (males, aged 24 and 31)                                        2. Gannon PF, Burge PS. The SHIELD scheme in the West
        exposure/jobs - zinc fume in welding                                         Midlands Region, United Kingdom. Midland Thoracic Society
                     - strong acid/alkali in a knackery worker                       Research Group. Brit J Indust Med 1993; 50: 791-796.
      • 1 had RADS & Bronchitis (male, age 46)                                    3. Gannon PF, Burge PS. A preliminary report of a surveillance
        exposure/job - not known                                                     scheme of occupational asthma in the West Midlands.
      • 2 had Bronchitis (male, age 63 and female aged 43)                           Brit J Indust Med 1991; 48: 579-582.
        exposure/job - road dust/road cleaner
                     - prawns/prawn packer
      • 15 agreed to follow-up


Correspondence: Prof Jon Ayres – Tel: 01224 558188; email:

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