The Drug-Induced Respiratory Disease Website

Heart block (bundle branch- or AV-)

AV block may be complete and/or irreversible

Alexandri M, Spaeth KR

Nontransient third-degree heart block and persistent respiratory findings as sequelae of acute occupational exposure to pyrethroids insecticide.

American journal of industrial medicine 2020 07;63;644-648 — 2020 07 — 644-648

Diagnosing DIRD

Drug and radiation history

Drug singularity - Correct identification of the drug

Consistent timing of exposure v. onset of symptoms

Clinical, imaging, BAL, pathological pattern consistent with the specific drug

Careful exlusion of another cause

Remission of symptoms with removal of drug

Recurrence with rechallenge (rarely advisable)

Causality assessment

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