Source: Annual Congress 2002 - Exposure to chemicals

Abstract

Shield is a joint project between the West Midlands branch of the Society of Occupational Medicine UK and the Midland Thoracic Society UK. The scheme, which was set up in January 1989, was established to meet three main objectives. 1) To study the general and specific incidence of occupational asthma within a defined geographic area with 2.2 million workers, 2) To determine proposed mechanisms of asthma, and 3) to audit diagnostic methods and objectives. The questionnaire covers confidential personal information on the patient, details of the diagnosis, information about their occupational history, and the outcome after diagnosis.
Results: 72 reports have been received so far for 2001. The most common cause of occupational asthma in 2001 was isocyanates (32%) and has been for the last ten years. 48% of the isocyanate notifications in 2001 were from an aluminium casting foundry which had an outbreak of occupational asthma involving 11 workers where the cores were bound with MDI. The other main agents reported were: Phenol Formaldehyde (14%), Chrome (11%), Latex (7%), Colophony and Welding fumes (6% each) and Flour, Zinc, Cobalt and Glutaraldehyde (4% each). Glutaraldehyde notifications have decreased since 2000 when they formed 10% of reported subjects, which may represent the substitution of glutaraldehyde with alternative, not necesarily safer, biocides. 54 different employers were reported to the scheme in 2001 and 33 (61%) were new to the scheme. A history of improvement of symptoms during holidays or periods off work still remains the most common method of diagnosis, however some form of objective confirmation was made in 83% of patients.
Conclusion: Shield remains an important tool to discover outbreaks of occupational asthma and to identify trends in causative agents.

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Citations should be made in the following way:
V. Huggins, W. Anees, A. Robertson, S. Burge (Birmingham, United Kingdom). Shield 2001; an update of a surveillance scheme of occupational asthma in the West Midlands, UK. Eur Respir J 2002; 20: Suppl. 38, 857

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