Occupational asthma with paroxysmal atrial fibrillation in a diamond polisher.

We present a case of a diamond polisher who developed occupational asthma as a result of prolonged exposure to various potent and well-recognized asthma-inducing agents, including cobalt dust. Although the patient was seen by various medical professionals during the initial course of his illness and given an early diagnosis of a respiratory condition, there were no attempts to evaluate the nature of his work, and therefore to establish a possible causal relationship with his exposures. This case clearly illustrates the importance of such an assessment. The ultimate fate of this patient (he had to retire from his job with a chronic and permanent illness) could have been avoided by early environmental intervention. In addition, this case illustrates a possible complication of asthma, that is, a severe cardiac arrhythmia. In this case, both the patient's symptoms and the prescribed medications contributed to worsening of the patient's underlying condition. Early diagnosis and intervention of this patient's work practices could have avoided this complication.