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Clinical Case Study 1

Clinical Case Study in Occupational and Environmental Medicine 

An animal house technician with skin rashes and respiratory symptoms


    A 20 year-old woman started work as an animal house technician, dealing mainly with rodents. She was given minimal training on commencement of exposure.  

    A few months later she developed symptoms of runny glazed and gritty eyes (conjunctivitis), stuffy, itchy and runny nose (rhinitis). She also had wheeze, tight chestedness, and shortness of breath (asthma) which improved on spells away from work. She noticed that when she was scratched by the rodents her skin very quickly developed raised red patches (urticaria). 

animals
    Her general practitioner prescribed treatment with bronchodilators, producing slight improvement but her symptoms persisted.  

    After about one year in employment she experienced an episode of angio-oedema and had serious difficulty with breathing. She was seen in a hospital casualty department, and treated with adrenaline and hydrocortisone. However no specific action in relation to her job was considered. After this episode she did not return to that work, and eventually resigned her employment. 

Arguably, from a medical standpoint the problem was solved. The work related nature of her symptoms had been demonstrated, at least circumstantially; she would no longer work in the animal house and her symptoms would be expected to resolve. 

Was the management of this occupational disease really adequate? 

What problems can you see in the way in which the case was handled, and how might these have been resolved?  backback................................................................nextnext


Acknowledgement:

This case study was adapted from Practical Occupational Medicine , and reproduced by kind permission of the publishers.