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Occupational asthma — SCE Respiratory MCQ

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ModerateOccupational lung diseaseOccupational asthmaSCE Respiratory

A 38-year-old bakery worker has cough, chest tightness and wheeze that improve during holidays and recur by the third day back at work. Baseline spirometry is normal and a single workplace peak flow measurement is unremarkable. Skin-prick testing is positive to flour. What is the most appropriate investigation?

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Correct answer: E — Serial peak expiratory flow at and away from work

Serial peak flow recordings several times daily across work and rest periods are the most useful initial objective test for suspected occupational asthma. A single post-shift spirometry result may miss work-related variability. HRCT and sputum culture do not establish the temporal relationship between workplace exposure and airflow variation.

Reference: BTS/NICE/SIGN Asthma Guideline 2024; BOHRF Occupational Asthma Guidance