Air-supplied respirators (airline respirators) have been recommended to limit exposure to diisocyanates in autobody shops. A later study concluded that negative pressure, air-purifying, half-face respirators equipped with organic vapor cartridges and paint prefilters provide effective protection against diisocyanate exposure in spray and priming operations if workers are properly trained and fitted.
Some preventive interventions focus on the individual worker, whereas other efforts are directed at groups of workers associated with particular worksites or at the worksite environment itself. Clinicians frequently encounter patients with possible WRA, and have both the opportunity and often an ethical responsibility to facilitate public health-based/population-based interventions in addition to caring for the individual patient. There can be a significant impact by communicating effectively with occupational health professionals (ie, clinicians and others).
Physicians are frequently in leadership positions in their own health-care industry facilities, which can have substantial exposures to cleaning agents, latex, and other factors linked to WRA, and they can institute changes more easily there than in factory settings. For example, many physicians have contributed to policies limiting unnecessary exposures to latex. Astute clinicians can discover heretofore unrecognized causes of sensitizer-induced OA by recognizing the temporal pattern associating symptoms or spirometry changes with work.
In the course of clinical practice, clinicians may uncover worksites and industries where cases of WRA occur due to known causative agents. The submission of appropriate reports to public health and care store surveillance and regulatory systems can link clinical and public health approaches. Several voluntary reporting programs have been established in the United States (Sentinel Event Notification System for Occupational Risks [or SENSOR]), the United Kingdom (Surveillance of Work-Related & Occupational Respiratory Disease [or SWORD]), and South Africa (Surveillance of Work-related and Occupational Respiratory Diseases in South Africa [or SORDSA]).