Occupational Lung Disease at the Centre
for Workplace Health
Whilst more traditional
forms of occupational associated with lung disease are now less
common in the UK, such as coal mining, the workplace continues
to evolve. As it does so, newer technologies and agents are
introduced. All new agents and tasks have at least the potential
to cause lung harm. One in 10 adult onset asthma is likely to
have an occupational component, and this clinic can help with
diagnostic issues.
The NHS occupational lung disease clinic at STI offers a full
consultant delivered and audited assessment of such possible
cases of occupational lung disease, and integrates this clinical
assessment with the multidisciplinary team, including
respiratory specialist nursing, physiologists and scientific
staff. A separate occupational clinic also offers medico legal
reports for respiratory cases, and sees patients referred from
occupational health professionals.
Nursing input is offered by one of three specialist nurses, Lisa
Bradshaw, Mandy Henson and Jan Brown. Physiological assessment
is offered by the Respiratory Function Unit [?html link to RFU],
with a wide experience in physiology testing relevant to
occupational lung disease. The scientific advice and support is
sourced from the Health and Safety Laboratory (HSL),
HSE’s national laboratory facility
based in Buxton.
This access is afforded by the
Centre for Workplace Health a
research centre of the University of Sheffield in collaboration
with HSL and Sheffield Teaching Hospitals NHS Foundation Trust.
Patients are assessed by one of two consultant respiratory
physicians:
Current diagnostic facilities available include:
-
Computer software
analysis of serial PEF data (OASYS 2)
-
Non-specific assessment
of bronchial responsiveness (histamine and methacholine)
-
Cough reflex
sensitivity assessment (citric acid)
-
Exhaled nitric oxide
measures
-
Workplace challenge and
workplace visit where appropriate
-
Purpose built challenge chamber
with specific allergen challenge (one of approximately six sites
nationally with this facility)
-
State of the art immunological
testing to a wide variety of workplace agents with a specific expertise
of measuring IgE to workplace agents
-
Biological monitoring, toxicology,
immunology and microbiological input via HSL
-
Access to modern imaging facilities
on site, and close working with the MDT clinic for lung cancer assessment
Current research interests are aimed to
make a difference for workers harmfully exposed to agents in the workplace,
using simple, practical solutions:
-
National and international
approaches to the diagnosis and management of occupational asthma
-
Development of a National Standard of
Care for occupational asthma
-
Occupational COPD diagnosis and health
surveillance
-
Health Surveillance for Crystalline
Silica Exposed Workers
-
Occupational lung disease and metal
working fluid exposure
-
Health effects of occupational
exposures in swine and poultry confinement
-
Occupational asthma and dermatitis in
the hairdressing and beauty industry
-
Education, training, and exposure
control in the baking industry
-
Immunological responses to inhaled
agents
-
Translation research to understand
better newer cellular tests of response to inhaled agents
Subspeciality lead for Occupational
Lung Disease is Dr
David Fishwick.
Please contact him directly for further
information.
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