Case 1 -
Patient may have Work-Related Asthma (Baker's asthma). She has obstruction at baseline and demonstrates a significant response to the use of a bronchodilator - results consistent with a diagnosis of asthma.
- Former Pipefitter
It appears that this patient has asbestosis with other radiographic findings that would be consistent with asbestos exposure (pleural abnormalities). Given the patient's smoking history, there may also be a component of Chronic Obstructive Pulmonary Disease (COPD).
- Bus Driver
It appears that this patient may have obesity related restrictive lung disease as well as possible significant obstructive sleep apnea (OSA).
Case 4 - Worker in Popcorn Factory
It appears that this patient may have bronchiolitis obliterans as a result of his work-place exposures at the Popcorn Factory. The finding of an obstructive lung defect with no responsiveness to the use of a bronchodilator would be consistent with a diagnosis of bronchiolitis obliterans, which is considered to be irreversible obstruction.
- Asymptomatic Worker with Low FEV1/FEV6%
In appears that this worker may have mild airways obstruction based on the FEV1/FEV6%, however; a closer analysis reveals that the test is invalid and the most likely reason for the low FEV1/FEV6% is an instrumentation error called a flow-zero error. It should be noted that the shortened 6-second maneuver (FEV6) should not be used as a surrogate for FVC in occupational surveillance programs. Narrative on Flow Zero Error
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