Occupational asthma caused by peracetic acid-hydrogen peroxide mixture.

Area of Science:

• Occupational Medicine
• Pulmonology
• Environmental Health

Background:

• UK healthcare has shifted from aldehyde disinfectants for endoscopes due to respiratory sensitization risks.
• Peracetic acid (PAA) combined with hydrogen peroxide (HP) is a prevalent alternative disinfectant.
• Concerns exist regarding the safety of PAA-HP mixtures in healthcare settings.

Purpose of the Study:

• To report a case of occupational asthma (OA) caused by exposure to a PAA-HP disinfectant mixture.
• To investigate the link between endoscope decontamination procedures and respiratory health issues.

Main Methods:

• A case study of a 48-year-old mycologist with symptoms suggestive of OA over 10 months.
• Diagnosis confirmed via OASYS analysis of serial peak expiratory flow measurements.
• Specific inhalation challenge test positive for PAA-HP mixture, showing a late asthmatic response.

Main Results:

• The patient experienced acute symptoms including lacrimation, eye pain, and headache after exposure to PAA-HP.
• Occupational asthma was diagnosed and linked to 12 months of exposure in the endoscopy department.
• A positive specific inhalation challenge confirmed PAA-HP mixture as the causative agent.

Conclusions:

• This case provides evidence for a sensitization mechanism in occupational asthma induced by PAA-HP mixtures.
• Highlights the need for vigilance regarding respiratory risks associated with PAA-HP disinfectants in healthcare.
• Suggests potential for PAA-HP to act as a respiratory sensitizer in occupational settings.