Evaluating a patient exposed to mold.
Muhlner S; Petrofsky Y
SENSOR Occup Lung Dis Bull 2011 Jul; :1-2
This Occupational Lung Disease Bulletin was written by two physicians during their rotations at OHSP while studying occupational medicine at the Harvard School of Public Health. They posted a version in the New England College of Occupational and Environmental Medicine newsletter. We appreciate their contributions to OHSP. A 32-year-old female logistic supply administrator presents to an occupational/environmental medicine clinic with a history of asthma symptoms that had progressively worsened over the past few months. She is concerned about mold exposure at the paper warehouse where she started working ten months ago and states "my workplace made me so sick that I had to quit." The building is a 1940s era brick building leased by three different occupants in an open space, with broken original floor tiles, a leaking roof, and water-stained walls. She describes her office as a damp open corner of the warehouse adjacent to the delivery truck loading docks. Her only fresh air source is a window that opens toward the loading dock. The warehouse has many openings to the outdoors and is infested with nesting and breeding pigeons and rodents. The patient states that she was having shortness of breath at work and at home, and would return home with visible black particulate surrounding her nostrils. She states that co-workers complained of the black-tinged mucous as well. The patient had been working at the warehouse for about five months before developing pneumonia. In summary, the patient with respiratory symptoms and exposure to dampness and mold on the job presents a challenge to the healthcare provider. A diagnosis of asthma may be straight forward. However, connecting the diagnosis to mold or dampness in the work environment may be challenging - because of limitations of both the biological testing and environmental sampling. Better understanding of these challenges can help providers make accurate diagnoses and appropriately manage care. A clinician's letter removing a patient from a hazardous environment and requesting that an employer abate the problem can be very influential.
Occupational-health; Work-environment; Workers; Occupational-exposure; Respiratory-system-disorders; Pulmonary-system-disorders; Bronchial-asthma; Surveillance-programs; Health-hazards; Air-contamination; Indoor-air-pollution; Worker-health; Occupational-diseases; Molds; Women; Warehousing; Health-care; Case-studies
Massachusetts Department of Public Health, Occupational Health Surveillance Program, 250 Washington Street, 6th Floor, Boston, MA 02108
SENSOR Occupational Lung Disease Bulletin
Massachusetts State Department of Public Health