Two workers (Case 1 and Case 2) of the Bronchoscopy Unit of the Pneumology Department, who, among other tasks, perform the chemical sterilization of bronchoscopies by using hydrogen peroxide-refillage agents other than
Case 1 and Case 2 present accidental exposure to steam-shaped peracetic acid after spillage of the product at high concentrations from inside the washing machine to outside.
Workers come to the Occupational Risks Service (SPRL) to communicate the incident and when there is suspicion of reactive airway syndrome, consultation to the allergy diagnostic service is requested for guidance
The symptoms and findings of the physical examination were in Case 1: Ocular and pharyngeal itching, dysphagia, headache, mild bilateral otalgia, pleurable characteristics of chest pain and wheezing lung fields discussed above.
And in Case 2: Significant dysphonia, pruritus and sensation of foreign body at the pharyngeal level, high-flow dyspnea, cough, wheezing and chest pain.
Both workers come to the Department of Otorhinolaryngology after exposure where fibrolaryngoscopy was performed.
Case 1 presented normal larynx, subglotis and upper trachea.
Case 2 presented edema of both vocal folds, preferably of the middle third of the left vocal cord.
Cutaneous examinations were performed and, in both cases, tests for hypersensitivity to aeroallergens with negative result and normal base paste were performed.
In Case 1, a chest CT was performed and no significant changes were detected and a methacholine test that did not reach a significant drop as objective criterion for positivity, although the fall test was interpreted as positive by the metamontMS administration of the last dose.
Case 2 presented chest X-ray without significant findings.
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The Allergology Department indicated that both cases corresponded to a Respiratory Tract Reactive Dysfunction Syndrome (RADS) due to peracetic acid.
