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Reactive airways dysfunction syndrome — DOccMed MCQ

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ModerateOccupational Lung DiseaseReactive airways dysfunction syndromeDOccMed

A 46-year-old pool maintenance worker develops cough and wheeze within hours of a chlorine gas release after mixing incompatible chemicals. He had no previous asthma and still has reversible airflow obstruction three months later. What is the most likely occupational diagnosis?

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Correct answer: D — Reactive airways dysfunction syndrome after acute irritant exposure

Reactive airways dysfunction syndrome follows a single high-level irritant exposure with rapid onset of asthma-like symptoms. Chlorine is an irritant rather than a classic sensitiser in this context. The lack of previous asthma and persistence of reversible obstruction support the diagnosis. Work-aggravated asthma would require pre-existing asthma.

Reference: HSE COSHH guidance; BTS/SIGN Asthma guidance