Patient does some baking at work & coughs with flour

Should I recommend she wear a mask? She doesnt want to stop doing this work and her asthma is generally much better since starting Clenil & Serevent inhalers earlier this year. However she's quite allergic to a number of things, including flour which she uses when in the bakery section at work (not all the time). She says she just turns her head away when using the loose flour to avoid triggering the cough. This patient doesn't speak English really well, so communicating with her isn't straight-forward. Any advice? I have read the Occupational Asthma sections on the website.

3 Replies

  • If she is dealing with food, coughing isn`t hygienic no matter what the cause

  • When I was allergy tested, one of the surprises on the RAST test was flour mites. Since my asthma has worsened I always make a point of wearing a mask when I am baking. Initially I pinched one of my husband's (new!) DIY masks and the next time he went to Tool Station I got him to buy me a box, which was not too expensive, and I keep them in the kitchen cupboard. It doesn't look too pretty, but needs must!

  • If she is at work, then her work should be looking at ways of controlling the levels of flour dust in the bakery through equiment e.g. ventillation general or extraction system. This can also include wearing personal protective equipment (PPE) e.g. masks if other measures do not control the situation. There also needs to be control through ways of working which includes operating procedures, supervision and training. It sounds like she needs some more training turning her head away is not ideal and not very hygienic.

    Where control measures are in place it is important to use them properly. This includes:

    wearing any PPE necessary; using control equipment; following hygiene procedures;

    warning supervisors if anything appears to be wrong.

    Basically from what you have said I am wondering what measures are in place and if the language barrier is causing an issue at work.

    I think that maybe you should be asking for permission to contact her work and occupational health to see if the situation can be improved. Your patient may need a referal to see a respiratory specialist as she may have occupational asthma. If she has occupational asthma this situation needs monitoring by her work, occupational health and her own GP/Consultant.

    If it is confirmed as occupational asthma any work related absceneces over 7 days for occupational asthma need reporting under RIDDOR.

    If she is having issues with her asthma she may well be advised not to work in areas where the flour is in use. If she continues working in this manner in the long term her asthma will eventually deteriorate.

    You may be able to get the appropriate leaflets in her language from the HSE or from the HPA or local PCT.

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