Abstract
Alcohol hand gels are increasingly being used by healthcare workers to reduce the risk of hospital-acquired infection. To date they have not been identified as a cause of occupational asthma in healthcare workers. We present two cases of occupational asthma in healthcare workers due to an alcohol hand gel containing a quaternary ammonium bittering agent (denatonium).
Two healthcare workers, a midwife (case 1) and a nurse (case 2), presented with asthma improving on days away from work. Both had developed symptoms in relationship to using the same alcohol hand rub. Both workers completed serial peak flow measures which showed occupational asthma (case 1 OASYS score 3.43, case 2 OASYS score 3.93). A series of bronchial challenge tests were performed to the hand gel and to a control agent. Case 1 had a dual asthmatic reaction and case 2 had a prolonged immediate reaction to the hand gel. Both workers improved on removal from exposure.
Hand gels containing denatonium are used extensively by healthcare workers. There needs to be an awareness of this agent as a potential cause of occupational asthma in this group of workers.
- © 2011 ERS
