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Work-aggravated asthma — DOccMed MCQ

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ModerateOccupational Lung DiseaseWork-aggravated asthmaDOccMed

A 33-year-old cleaner with childhood asthma reports chest tightness during evening shifts using bleach and descaler in poorly ventilated toilets. Spirometry confirms reversible obstruction; peak-flow charts show symptoms on heavy cleaning days but also during viral infections at home. What is the most likely occupational diagnosis?

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Correct answer: A — Work-aggravated asthma due to irritant cleaning exposures

Pre-existing asthma that worsens with irritant exposure is work-aggravated asthma. The history lacks a new sensitiser pattern or a single high-level exposure causing reactive airways dysfunction. Viral-triggered symptoms outside work support underlying asthma. Management should focus on control of irritant exposure as well as clinical asthma care.

Reference: HSE Occupational Asthma guidance; COSHH Regulations