Nebulisers are machines that turn the liquid form of your short-acting bronchodilator medicines into a fine mist, like an aerosol. You breathe this in with a face mask or a mouthpiece. Nebulisers are no more effective than normal inhalers. However, they are extremely useful in people who are very tired (fatigued) with their breathing, or in people who are very breathless. Nebulisers are used mainly in hospital for severe attacks of asthma when large doses of inhaled medicines are needed. They are used less commonly than in the past, as modern spacer devices are usually just as good as nebulisers for giving large doses of inhaled medicines. You do not need any co-ordination to use a nebuliser - you just breathe in and out, and you will breathe in the medicine.
Clear guidelines for the treatment of occupational COPD are currently lacking. 26 Physicians should work with patients and employers to eliminate respiratory exposures. Primary prevention strategies include identification of workplace hazards and use of personal protective equipment, and secondary prevention focuses on medical surveillance with the use of symptom questionnaires. 26 , 27 Family physicians should encourage and support smoking cessation. There is no evidence that the use of inhaled corticosteroids, long-acting beta agonists, or leukotriene modifiers changes the prognosis of occupational COPD. 27