Praćenje vršnog ekspiratornog protoka u dijagnozi profesionalne astme: serija slučajeva

professional thesis

• Title (english): Peak expiratory flow monitoring in the diagnosis of occupational asthma: a series of cases
• Author: Dina Smiljan
• Mentor: Jelena Macan (mentor)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2018-12-04, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Public Health

Abstract

Prema podacima iz Registra profesionalnih bolesti Hrvatskog zavoda za zaštitu zdravlja i sigurnost na radu, u posljednjih 9 godina (2008.-2016.) prijavljeno je samo 19 slučajeva profesionalne astme od ukupno 2062 prijavljene profesionalne bolesti. To upućuje na značajne nedostatke u prepoznavanju ovog poremećaja u našoj radnoj populaciji. Cilj ovog rada je kroz prikaz serije slučajeva opisati standardnu metodu praćenja vršnog ekspiratornog protoka zraka (eng. peak expiratory flow, PEF) i predložiti praktičnu smjernicu za korištenje ove dijagnostičke metode u ambulantama medicine rada i sporta.
Praćenje vršnog ekspiratornog protoka zraka (PEF-monitoring) je jednostavna, jeftina, neinvazivna i pouzdana metoda za utvrđivanje funkcije dišnog sustava u stvarnim uvjetima rada i radnog okoliša. Trenutne smjernice preporučuju PEF-monitoring kao inicijalnu dijagnostičku metodu prilikom sumnje na profesionalnu astmu. Pozitivan test ukazuje na povezanost promjene plućne funkcije s radnom izloženošću i čini važan dio dijagnostičkog procesa utvrđivanja profesionalne astme. Najveći nedostatak ove metode je da se ovim testom ne može utvrditi uzrok astme, tj. on ne razlikuje profesionalnu astmu od astme pogoršane na radu, nema standardizirane metode za interpretaciju rezultata, a mjerenja provode sami radnici pa su moguće namjerne i nenamjerne manipulacije rezultatima mjerenja.
Predložena je praktična smjernica za primjenu ove metode u ambulantama medicine rada i sporta s preporukama protokola mjerenja PEF-a, prikaza rezultata mjerenja i njihove interpretacije u sklopu dijagnosticiranja profesionalne astme.

Abstract (english)

According to data from the national Register of Occupational Diseases (Croatian Institute for Health Protection and Safety at Work), 19 cases of occupational asthma were reported in the last 9 years (2008-2016) out of the total of 2062 registered occupational diseases. This indicates insufficient diagnosing and recognition of this disorder in our working population. The aim of this paper is to describe the standard method for peak expiratory flow (PEF) monitoring through series of cases and to suggest a practical guideline for using this diagnostic tool in occupational & sport medicine practices.
PEF monitoring is a relatively simple, inexpensive, non-invasive and robust method for determining the function of the respiratory system in real working conditions and environment. Current guidelines recommend PEF monitoring as an initial diagnostic tool for cases of suspected occupational asthma. A positive test indicates the association between changes in lung function and work exposure, and makes an important part in the diagnostic procedure for cases of suspected occupational asthma. However, this test cannot determine the cause of asthma because it does not distinguish occupational asthma from work-aggravated asthma, there is no standardized method for interpretation of results, and its measurements are carried out by workers themselves, so intentional and unintentional manipulations with measurements can be made.
A practical guideline for usage of this diagnostic method in occupational and sport medicine practices, with special reference to the protocol of PEF measurements, presentation and interpretation of findings, is suggested as a part of the diagnostic procedure for occupational asthma.

• Keywords: astma pogoršana radom; bronhoprovokacijski testovi; dišni iritansi; profesionalna astma; profesionalni inhalacijski alergeni; rinitis povezan s radom; vršni ekspiratorni protok zraka
• Keywords (english): bronchoprovocation testing; occupational asthma; occupational inhalatory allergens; peak expiratory flow; respiratory irritants; work-aggravated asthma; work-related rhinitis
• Language: croatian
• URN:NBN: urn:nbn:hr:105:391654
• Study programme: Title: Leadership and management of health services; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra menadžmenta u zdravstvu (sveučilišni/a magistar/magistra menadžmenta u zdravstvu)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Repository: Dr Med - University of Zagreb School of Medicine Digital Repository
• Created on: 2021-05-10 08:03:25