Correctional officer with asthma

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Correctional officer with asthma

Post by Dcsmd » Fri Dec 28, 2018 1:11 pm

Good afternoon,

I have a case of a 34-year-old correctional officer applicant with a history of childhood asthma, last needed inhalers at the age of 16. The POST (California Peace Officer Guidelines) which we are required to use for both Police and Correctional Officers disqualifies a candidate with exercise-induced asthma or asthma requiring maintenance therapy.

The candidate went for a pulmonary evaluation and had:

Pre-exercise: FEV1/FVC = 97% of predicted
FEV1 = 99% of predicted
FEF 25-75 = 61% of predicted.

Post-exercise: FEF 25-75 was 83% of predicted.

The pulmonary evaluation documented audible wheezing and recommended this candidate take long acting beta 2 agonist + steroid inhalers and short-acting beta 2 agonist inhalers as needed and 1/2 hr prior to exercise.

Seeing that the POST is mainly directed to Patrol Officers and the ACOEM LEO Guidelines haven't posted a section on pulmonary disorders yet, does anyone have similar cases or literature that I can refer to?

Thank you very much, I appreciate your comments and suggestions.


Robert Swotinsky MD
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Re: Correctional officer with asthma

Post by Robert Swotinsky MD » Sun Dec 30, 2018 10:03 am

The pulmonary function test results do not identify an obstructive pattern that establishes a diagnosis of asthma. An obstructive pattern on pulmonary function tests is identified by an FEV1/FVC of less than 0.70 or less than the lower limit of normal. In the case as presented, the FEV1/FVC is normal.

In the case as presented, the support for asthma appears to be based on a childhood history of asthma, a reduced FEF 25-75, and a pulmonary specialist's recommendation to take asthma-type medicines prior to exercise and PRN. None of these factor is specific for asthma. Where possible, a diagnosis of asthma should be validated with objective data. In this case, the data do not corroborate asthma - not exercise-induced asthma, and not asthma that requires maintenance therapy.


Re: Correctional officer with asthma

Post by Dcsmd » Thu Jan 24, 2019 3:22 pm

Thank you. I appreciate the comment.


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