ABSTRACT
Symptoms usually occur after several years of employment, and include the following: • chest tightness: this typically occurs on return to work on Monday or the
first shift of the week, or following a holiday or longer break. The following day the patient feels normal and usually does so for the rest of the week. There may be no further progression of symptoms for years. After many years, they may notice that the chest tightness persists further into the week, although symptoms are usually worst on Mondays;
• chronic cough and breathlessness may develop. Initially, symptoms are reversible. Later, they are not.
