title: Peak expiratory flow analysis in workers exposed to detergent enzymes.
abstract: OBJECTIVE
  To study serial peak expiratory flow (PEF) responses in a group of symptomatic detergent enzyme-exposed workers.
  
  
  METHODS
  Workers were recruited from a biological detergent formulating and packaging company. Those with occupational asthma symptoms and/or specific IgE to a detergent enzyme were asked to complete 2 hourly PEF measurements for 4 weeks. Outputs from the Oasys program (Oasys score, rest-work score and rest-work difference in diurnal variation) assessed PEF response. These were then related to the levels of sensitization and current occupational exposure to detergent enzymes.
  
  
  RESULTS
  In all, 67/72 workers returned PEF records; 97% were able to return a record with at least four readings per day and 87% at least 3 weeks in length. Of total, 79% (n = 27) of those with a final diagnosis of occupational asthma had peak flow records confirming the disease using Oasys. PEF response was similar in those with high, medium and low levels of exposures and those with negative, low-moderate and high specific IgE levels.
  
  
  CONCLUSIONS
  The Oasys program is a sensitive tool for the diagnosis of detergent enzyme occupational asthma, but the levels of exposure and specific IgE sensitization to enzymes do not affect the magnitude of PEF response in symptomatic workers.
authors.affiliation: Occupational Lung Disease Unit, Department of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK. vicky.c.moore@heartofengland.nhs.uk
authors.forename: Vicky C
authors.initials: VC
authors.lastname: Moore
authors.forename: Paul
authors.initials: P
authors.lastname: Cullinan
authors.forename: Steven
authors.initials: S
authors.lastname: Sadhra
authors.forename: P Sherwood
authors.initials: PS
authors.lastname: Burge
mesh_terms: D000328:Adult; D002940:Circadian Rhythm; D003902:Detergents; D005260:Female; D006801:Humans; D006867:Hydrolases / Q000009:adverse effects* / Q000276:immunology; D006969:Hypersensitivity, Immediate / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D010366:Peak Expiratory Flow Rate / Q000502:physiology*; D012146:Rest; D012680:Sensitivity and Specificity; D014937:Work
chemical_list: D003902:Detergents; D007073:Immunoglobulin E; D006867:Hydrolases