This summary was compiled from the tweets posted by the following allergists/immunologists who attended the 2012 annual meeting of the American Academy of Allergy Asthma and Immunology (AAAAI): Dr. Melinda Rathkopf @mrathkopf and Nathaniel Hare M.D. @DrNathanHare. The tweets were labeled #AAAAI. The text was edited and modified by me.
Occupational Asthma (OA): Leasons Learned from Seafood Workers, a lecture by Dr. Andre Cartier:
10% of all adult onset asthma is due to occupational asthma.
15.2% of workers in a specific snow crab processing plant were diagnosed with occupational asthma. Processing cooked vs. raw crab - allergen concentration in air higher when processing cooked crab.
Occupational asthma is asthma that is worse at work, and improving over weekends or holidays. It is often associated with rhinoconjunctivitis and skin rashes.
Occupational Asthma (click to enlarge the image).
Questions to ask:
- Wheezing at work?
- Improved over weekend, over holidays?
- Nasal itching at work?
- Loss of voice at work?
Diagnosis must be confirmed. History alone can't make diagnosis of OA.
A negative methacholine challenge doesn't exclude OA when not at work. However, a negative methacholine challenge in a symptomatic individual while at work makes OA unlikely.
Again, a negative methacholine challenge in a symptomatic worker at work makes it unlikely they have occupational asthma.
The allergist can monitor peak flows and PC20 to confirm exacerbation of asthma at work. You have to confirm that asthma is work-related, therefore follow peak flow/ PC20 as they are at work and when off. Peak flow QID at least, or q2hrs, 2 weeks at work and 2 wks off, the patient has to be symptomatic.
Consider a work visit for OA: check air sample, ask about other sick workers. Air samples at work for OA: sample multiple areas because levels of allergens may vary.
Specific inhalation challenges are the gold standard to confirm OA. A 20% drop in FEV1 from baseline is required.
Agents associated with occupational asthma (click to enlarge the image).
Work-related Asthma - AAAAI COLA video lecture by David Bernstein, MD, 07/2012:
Allergists achieved highest use of social media by any specialty
During the 2012 AAAAI meeting, the allergists achieved the highest use of social media by any specialty. There are more than 100 allergists on Twitter and 30 of them posted simultaneously from the annual meeting, broadcasting thousands of tweets tagged with #AAAAI. The annual AAAAI meeting was attended by approximately 5,000 people. In comparison, the 30 allergists on Twitter reached 250,000 people (measured by TweetReach.com on 03/04/2012).
This summary was compiled from some of the tweets posted by Dr. Melinda Rathkopf @mrathkopf and Nathaniel Hare M.D. @DrNathanHare. I would strongly encourage you to post updates on Twitter from the CME conferences that you are planning to attend in the future. Here is how to do it: Twitter for Physicians: How to use Twitter to keep track of the latest news and scientific meetings, and share information with colleagues and patients.
Disclaimer: The text was edited, modified, and added to by me. This is one of a series of posts that will be published during the next few weeks.