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Case Report
Occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range: a case report
Kwang Min Lee, Seungho Lee, Yoon-Ji Kim, Seung-eun Lee, Youngki Kim, Dongmug Kang, Se-Yeong Kim
Ann Occup Environ Med 2023;35:e13.   Published online June 19, 2023
DOI: https://doi.org/10.35371/aoem.2023.35.e13
AbstractAbstract AbstractAbstract in Korean PDFSupplementary MaterialPubReaderePub
Background

Indoor air pollution can cause and exacerbate asthma. We report a previously undescribed case of occupational asthma related to indoor air pollution in a worker at an indoor air gun shooting range and highlight the potential risk of developing occupational asthma in this environment.

Case presentation

A 31-year-old man presented with dyspnea, cough, and sputum and was diagnosed with asthma complicated by pneumonia. Objective evidence of asthma was obtained by performing a methacholine bronchial provocation test. It was suspected that the patient had occupational asthma, which began one month after changing jobs to work within the indoor air gun shooting range. The highest peak expiratory flow (PEF) diurnal variability on working days was 15%, but the highest variation was 24%, with 4 days out of 4 weeks having a variation of over 20% related to workplace exposure. Conversely, the diurnal variability on the rest days was 7%, and no day showed a variation exceeding 20%. The difference in the average PEF between working and rest days was 52 L/min. PEF deterioration during working days and improvement on rest days were noted.

Conclusions

The results obtained from the in-depth analysis of the PEF were adequate to diagnose the patient with occupational asthma. Exposure to indoor air pollution and lead and the patient’s atopy and allergic rhinitis may have contributed to the development of occupational asthma.

실내 공기총 사격장 근로자의 실내공기오염관련 직업성 천식 증례보고
a배경: 실내공기오염은 천식을 유발하고 악화시킬 수 있다. 본 연구는 실내 공기총 사격장에서 일하는 근로자의 실내 공기 오염과 관련된 이전에 기술되지 않은 직업성 천식 사례를 보고하고, 이러한 환경에서 직업성 천식 발병의 잠재적 위험을 강조한다.
증례
31세 남자가 호흡곤란, 기침, 가래 증상이 나타나 내원하였고, 폐렴이 동반된 천식으로 진단되었다. 천식의 객관적인 증거는 메타콜린 기관지유발검사를 시행하여 획득하였다. 환자는 실내공기총 사격장에서 근무하기 위해 이직한지 한달만에 직업성 천식을 앓고 있는 것으로 의심되었다. 근무일의 최고호기유량(PEF) 주간 변동성은 15%였지만, 가장 높은 변동성은 24%였으며, 4주 중 4일은 작업장 노출과 관련하여 20% 이상의 변동성을 보였다. 반대로 쉬는 날의 일교차는 7%로 20%를 넘는 날은 없었다. 근무일과 휴식일 사이의 평균 최고호기유량(PEF) 차이는 52 L/min이었다. 근무일 동안 PEF 악화 및 휴식일의 개선이 주목되었다.
결론
최고호기유량(PEF)의 심층분석결과는 직업성 천식 환자를 진단하기에 적합하였다. 실내공기오염과 납 노출, 환자의 아토피와 알레르기성 비염이 직업성 천식 발병에 기여했을 가능성이 있다.

Citations

Citations to this article as recorded by  
  • Recent developments in occupational asthma
    Claudia Blouin, Catherine Lemière
    Current Opinion in Pulmonary Medicine.2024; 30(3): 281.     CrossRef
  • Occupational agents-mediated asthma: From the perspective of autophagy
    Xiu He, Dengxiang Yao, Xiaoli Yuan, Jiaqi Ban, Yuxuan Gou, Mingdan You
    Science of The Total Environment.2024; 952: 175880.     CrossRef
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Original Article
The effect of Residential Environments on the Bronchial Hyperresponsiveness
Sang Sup Kim, Hyung Joon Chun, Domyung Paek, Rokho Kim, Ho Kim
Korean Journal of Occupational and Environmental Medicine 2000;12(2):157-169.   Published online June 30, 2000
DOI: https://doi.org/10.35371/kjoem.2000.12.2.157
AbstractAbstract PDF
OBJECTIVES
The increased prevalence of asthma over the last 30 years has been reported from many different countries, including Korea. The increased prevalence may be due to increased exposure to indoor air pollutants.
METHODS
In this study, the relationship between residential environments and airway hyper-responsiveness has been examined among 280 family members. The bronchial hyper-responsiveness was expressed as the log-transformed slope of FEV decrease over the log-transformed dose of methacholine concentration(BRindex). Simple regression analysis was done for the effect of sex, age, atopic status, and residential environments including active and passive smoking exposures on airway responsiveness. Based on simple regression results, multiple rwegression analysis was performed for total group and also according to sex.
RESULTS
The mean of BRindex of residents living in gas boiler heating houses was higher than that of central heating system (p=0.014). Smoking status was a significant determinant of bronchial hyper-responsiveness in both genders; male(p=0.017), female (p%.022). In the male group the mean of BRindex of current smokers was significantly higher than those of ex-smokers and non-smokers, and the mean of BRindex of passive smokers was higher than that of non-smokers, but statistical significance was border-line(p=0.069). In female group, the mean of BRindex of kerosene stove users was higher than that of non-users(p=0.057).
CONCLUSIONS
This study suggests that indoor air pollutants including type of heating, passive smoking and kerosene stove use can contribute to the increase in asthma prevalence in Korea.

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