SOMMAIRE

Mise-à-jour
16-Jul-2003

Jobs/Métiers

Arboriculturist, Farmer, Gardener, Wine grower

Panonychus Citri,  Panonychus ulmi, Plasmopara Viticola, Tetranichus Urticae

Incidence will vary from year to year. Subjects are usually atopic. IgE-dependent mechanism for subjects with respiratory symptoms. Irritation of an unknown origin is often also present. Symptoms are particularly common during the fruit picking season (autumn). There is common antigenicity between Tetranychus urticae, Panoncychus citri and Panonychus ulmi (respective inhibition between 83% and 71.6%). Concerning Dermatophagoides pteronyssinus and Tyrophagusputrescentiae, a partial cross-reactivity of 54.4% and 57.7% with Panonychus ulmi has been demonstrated. Furthermore, partial cross-reactivity exists between all these mites and Anisakis simplex. In farmers, sensitisation may occur throughout the year depending upon the work they are performing.

Sensitisation to mite excretions in dust during particularly dry summers, and especially to tetranychus urticae (red spider mite). Similarly for Plasmopara viticola during humid autumnal periods (vines). Fungicides and pesticides may aggravate the condition. Fruit growers are most at risk : apples (panoncychus ulmi and tetranychus uritcae); lemons (paronychus citri). Additionally, 6% of farmers show sensitivity to Tetranychus urticae).

Rhinitis, spasmodic cough, conjunctivitis and asthma. Eczema, dermatitis and pruritus on exposed skin.

Skin tests and bronchial provocation tests with the Panoychus Ulmi or Plasmophara viticola extracts (these extracts are not currently commercially available).

Allergy, 2001,56:1157 - Astarita C. et al.
Clin. Exp. Allergy 2001,31:1457 - Kim Y. et al.
Allergy, 2001,56:660 - Johansson E. et al.
Am Allergy Asthma Immunol 1999,82 : 223 Kim Y et al.
J. Allergy Clin. Immunol. 1999,104:1285 - Yoon-Keun Kim et al.
Clin. Exp. Allergy 1997,27:640 - Delgado J. et al.
Clin. Exp. Allergy 1994,24:477 - Delgado J. et al.
J. Allergy Clin. Immunol. 1994,93:457
Rev. Fr. Allergol. 1977,17:93

1. [Medline]  Astarita C, Gargano D, Manguso F, Romano C, Montanaro D, Pezzuto F, Bonini S, Altucci P, Abbate G.
   Epidemiology of allergic occupational diseases induced by Tetranychus urticae in greenhouse and open-field farmers living in a temperate climate area.
   Allergy. 2001 Dec;56(12):1157-63. MID: 11736744

2. [Medline] Kim YK, Oh SY, Jung JW, Min KU, Kim YY, Cho SH.
   IgE binding components in Tetranychus urticae and Panonychus ulmi-derived crude extracts and their cross-reactivity with domestic mites.
   Clin Exp Allergy. 2001 Sep;31(9):1457-63. PMID: 11591197
   Clin. Exp. Allergy 2001,31:1457 - Kim Y. et al.

3. [Medline] Johansson E, Aponno M, Lundberg M, van Hage-Hamsten M.
   Allergenic cross-reactivity between the nematode Anisakis simplex and the dust mites Acarus siro, Lepidoglyphus destructor, Tyrophagus putrescentiae, and Dermatophagoides pteronyssinus.
   Allergy. 2001 Jul;56(7):660-6. PMID: 11421925

4. [Medline] Kim YK, Son JW, Kim HY, Park HS, Lee MH, Cho SH, Min KU, Kim YY. Related Articles, Links
   New occupational allergen in citrus farmers: citrus red mite (Panonychus citri).
   Ann Allergy Asthma Immunol. 1999 Feb;82(2):223-8. PMID: 10071529

5. [Medline] Delgado J, Orta JC, Navarro AM, Conde J, Martinez A, Martinez J, Palacios R. Related Articles, Links
   Occupational allergy in greenhouse workers: sensitization to Tetranychus urticae.
   Clin Exp Allergy. 1997 Jun;27(6):640-5. PMID: 9208184

6. [Medline] Delgado J, Gomez E, Palma JL, Gonzalez J, Monteseirin FJ, Martinez A, Martinez J, Conde J.
   Occupational rhinoconjunctivitis and asthma caused by Tetranychus urticae (red spider mite). A case
   report. Clin Exp Allergy. 1994 May;24(5):477-80. PMID: 8087660 

Jobs/Métiers

Butcher, Cook , Farmer, Food industry

Alliumcepa seed, Aniseed, Asparagus, Bay leaf, Cinnamon, Clove, Garlic, Garlic dust, Mace, nutmeg, Rosemary

Incidence: rare.

Subjects are usually atopic.

IgE-dependent mechanism.

The antigen is widespread throughout the lily family : cross reactions may occur with other members of the family, e.g. onion, asparagus or chives. However, different antigens are involved for the red onion and onion seeds (risk of asthma during packaging). A case of asthma has been described following inhalation of barley flour. A further report identified asthma caused by consumption of beer. There are partial cross-reactions between grass pollens and the chenopodes, particularly in the lily family.

Rhino-conjunctivitis, asthma and eczema. Anaphylactic reactions are possible in sensitive subjects following ingestion of raw garlic.

Diagnostic

Skin prick test with garlic extract: initial dose 1/100000 m/v

Immunological dosage: RAST/CAP RAST garlic and PTRIA. For other aromatic herbs, extracts should be prepared just prior to use.

Allergy 1998,53:1216 Lopez Rubio A. et al.
J. Allergy Clin. Immunol. 1997,100:734 - Añibarro Belén et al.
Allergy 1996,51:647
Allergy 1996,51:337
Allergy 1995,98:690
J. Allergy. Clin. Immunol. 1982,69:448.
J. Allergy. Clin. Immunol. 1981,68:156.
Rev. Fr. Allergol. 1980,20:145.

1. [Medline] .Lopez-Rubio A, Rodriguez J, Crespo JF, Vives R, Daroca P, Reano M.
   Occupational asthma caused by exposure to asparagus: detection of allergens by immunoblotting
   Allergy. 1998 Dec;53(12):1216-20. PMID: 9930601 

2. [Medline]  Anibarro B, Fontela JL, De La Hoz F.
   Occupational asthma induced by garlic dust.  J Allergy Clin Immunol. 1997 Dec;100(6 Pt 1):734-8. PMID: 9438479

3. [Medline]  Lemiere C, Cartier A, Lehrer SB, Malo JL.
   Occupational asthma caused by aromatic herbs. Allergy. 1996 Sep;51(9):647-9. PMID: 8899117

4. [Medline] Fraj J, Lezaun A, Colas C, Duce F, Dominguez MA, Alonso MD.
   Occupational asthma induced by aniseed. Allergy. 1996 May;51(5):337-9.  PMID: 8836339 

5. [Medline] Falleroni AE, Zeiss CR, Levitz D.
   Occupational asthma secondary to inhalation of garlic dust. J Allergy Clin Immunol. 1981 Aug;68(2):156-60. PMID: 7252000

6. [Medline] Lybarger JA, Gallagher JS, Pulver DW, Litwin A, Brooks S, Bernstein IL.
   Occupational asthma induced by inhalation and ingestion of garlic. J Allergy Clin Immunol. 1982 May;69(5):448-54. PMID: 7076985 

Jobs/Métiers

Baker, Butcher, Cannery factory employee, Confectioner, Cook, Delicatessen, Food industry, Grocer

Animal dander, Aniseed, Barley, Buckwheat, Cocoa, Crab, Eggs (Vitellus), Enzymes, Flours, Honey, Milk, Pectin, Pork, Sea food, Sera, Starch, Talc, Vegetable debris

Incidence: proportional to the frequency and duration of the exposure to the risk and directly related to the work place conditions. Subjects are often atopic, but non-atopic subjects may be affected. The mechanism is IgE-dependent, but some cases of alveolitis have been reported (contamination). The delay before the appearance of symptoms is very variable depending on the quantity and the nature of the antigen inhaled. Smoking aggravates the respiratory symptoms.

Sensitisation by inhalation. The modern food industry produces many dehydrated and powdered products (which may generate fine airborne particles). Inhalation of vapours produced during cooking may also provoke asthma. However, the products themselves may provoke asthmatic attacks : in Asia, cases of asthma have been described resulting from inhalation of buckwheat flour during the production of pasta. The increasingly frequent use of spices in food preparations has increased the risks (Umbellifers). Other cases in the fruit canning industry have been reported : dipping of fruits in enzyme-containing baths.In the case of snow crabs, the presence of the allergen has been reported in cooking vapours by fish processing factories.

Asthma is sometimes preceded by, and is often associated with rhinitis and conjunctivitis. Digestive irritation or allergy can occur when the agent has been ingested. Risks of anaphylaxis occur when subjects who have been sensitised by inhalation at the workplace ingest the product (buckwheat flour). Conversely, in one case of work-related asthma due to aniseed, the ingestion of this plant product had no clinical effect.

Diagnostic

Skin prick tests, identification of specific IgE and particularly bronchial provocation tests (in Hospital) enable the diagnosis to be made.

Allergy 1999,54:183 - Johnson A et al.
Allergy 1997,52:886 - Rodriguez J. et al.
Allergy 1997,52:778 - Perfetti L. et al.
Clin. Exper. Allergy 1998,28:363 -Sen D. et al.
Clin. Exper. Allergy 1997,27:75 - Malo J.L. et al.
Allergy 1996,51:337 - Fraj J. et al.
Rev. Mal. Resp. 1997,14:319 - Choudat D. et al.
Rev. Fr. Allergol. 1995,35:444
Clin. Exper. Allergy 1996,26:423
Allergy 1996,51:272
J. Allergy Clin. Immunol. 1995,96:608
Occup. Environ Med. 1994,51:7
J. Allergy Clin. Immunol.1994,94:33
Irish Med. J.1985,78:321;
Chest 1993,1:103;
Rev. Med. Ind. 1989,9:495;
La Presse Médicale 1986,15, n°34:1712;
Rev. Fr. Allergol. 1984,24,2:93;
J. Allergy Clin. Immunol. 1985,76:477;
J. Allergy Clin. Immunol. 1984,74:261;
Environ Reps. 1988,47:65;

1. [Medline] Johnson A, Dittrick M, Chan-Yeung M.
   Occupational asthma caused by honey. Allergy. 1999 Feb;54(2):189-90. No abstract available. PMID: 10221448

2. [Medline] Rodriguez J, Reano M, Vives R, Canto G, Daroca P, Crespo JF, Vila C, Villarreal O, Bensabat Z.
   Occupational asthma caused by fish inhalation. Allergy. 1997 Aug;52(8):866-9.PMID: 9284987 

3. [Medline] Perfetti L, Lehrer SB, McCants M, Malo JL.
   Occupational asthma caused by cacao. Allergy. 1997 Jul;52(7):778-80. No abstract available. PMID: 9265998

4. [Medline] Sen D, Wiley K, Williams JG.
   Occupational asthma in fruit salad processing. Clin Exp Allergy. 1998 Mar;28(3):363-7. PMID: 9543087 

5. [Medline] Malo JL, Chretien P, McCants M, Lehrer S.
   Detection of snow-crab antigens by air sampling of a snow-crab production plant.
   Clin Exp Allergy. 1997 Jan;27(1):75-8. PMID: 9117885 

6. [Medline] Fraj J, Lezaun A, Colas C, Duce F, Dominguez MA, Alonso MD.
   Occupational asthma induced by aniseed. Allergy. 1996 May;51(5):337-9. PMID: 8836339.

7. [Medline] Choudat D, Villette C, Dessanges JF, Combalot MF, Fabries JF, Lockhart A, Dall'Ava J, Conso F.
   Occupational asthma caused by buckwheat flour. Rev Mal Respir. 1997 Sep;14(4):319-21. French. PMID: 9411616

Jobs/Métiers

Foundry worker, Metallurgist

Aluminium, Aluminium salts, Fluorides

Incidence less than 4%.

Smoking is a common habit amongst these workers and aggravates the condition. The inflammatory factor caused by the irritant plays a role in the development of chronic symptoms. Bronchial hyperreactivity and airways obstruction syndrome may persist after exposure to the risk has ceased. Aluminium sulphates and fluorides used during the electrolytic extraction process are toxic. Elevated levels of blood eosinophils may be a risk factor.

The sulphates and fluorides of aluminium used during the electrolytic extraction process are toxic. The limit for occupational exposure is 0.5 mg/m3.

Excessive inhalation of fluorides may give rise to RADS (Reactive airways dysfunction syndrome or asthma caused by irritants – Brooks syndrome).

Cough, dyspenoea, wheezing and difficulty in breathing are frequent symptoms. Initially, the symptoms are directly associated with exposure to the risk (ceasing at the weekend), but may eventually become permanent with time.

In the past, the causative agent was unclear: either it could have been an irritant action due to a hydrogenated fluoride or a specific reaction due to aluminium chloride. It has now become clear that the reaction is specific and due to aluminium chloride and this has been demonstrated by bronchial provocation tests.

Diagnostic

No immunological assay or bronchial provocation test. An epidemiological approach must be adopted for diagnosis. Plasma fluoride concentrations of up to 10 ng/ml have been observed. The plasma concentration is directly related to the exposure.

INRS 2000 DMT 82 TR 25 page 153 Rosenberg N
Allergy 2000,55:779 Burge P.S. et al.
Fiche INRS numéro 21 DMT 46 Rosenberg N
Eur. Resp. J. 1995,8:1520
Thorax 1994,49:984
Br. J. Ind. Med.1991,48:635
Thorax 1992,47:292
Med. Lav. 1981,72:301
Am. Rev. Respir. Dis. 1989,139:1042
Am. J. Ind. Med. 1989,15:43
Am. J. Ind. Med. 1986,9:239
Eur. J. Resp. Dis. 1985,66:105

1. [Medline] INRS 2000 DMT 82 TR 25 page 153 Rosenberg N  http://www.inrs.fr/produits/revues/dmt82.htm 

2. [Medline] Fiche INRS nro 21 DMT 46 Rosenberg N. http://www.inrs.fr/dossiers/fichtox/acces_nom.htm 

3. [Medline] Burge PS, Scott JA, McCoach J.
   Occupational asthma caused by aluminum. Allergy. 2000 Aug;55(8):779-80. No abstract available. PMID: 10955707

Jobs/Métiers

Adhesives industry, Cosmetics industry, Electronics, Furrier, Metallurgist, Organic chemistry industry, Petrochemical industry, Pharmaceutical industry, Photographic processing, Plastics industry, Rubber industry, Tanner

Amines, Aziridine, Diamines, Diethanolamine, Ethanol amines, Ethylamine, Ethylene diamine, Methylamine, Tetramines, Triamines

Incidence: one in three exposed subjects develop symptoms.

Underlying non-specific bronchial hyperreactivity is a predisposing factor. Amines can liberate histamines directly and via cholinergic routes. Aldehydes can cause sensitisation (IgE-dependent mechanism) and may also give rise to RADS (Reactive airways dysfunction syndrome or irritant induced asthma- Brooks syndrome)..

Preventative measures are particularly important since the number of subjects affected is directly related to work place conditions. These agents are used as cold hardening agents in the epoxide resin industry. At high concentrations, direct contact with ethanolamine induces irritative lesions. Heating of diethanolamine to between 40°C and 60°C  results in a vapour which can induce sensitisation in subjects present in the work place and provoke asthmatic attacks.

Rhinitis and early asthma following exposure, quite frequently associated with eczema. Respiratory symptoms often persist after exposure has ceased.

Diagnostic

Bronchial provocation tests by inhalation (in Hospital).

Skin prick tests with dimethylethanolamine at 1/1000, 1/100, 1/10 (m/v) or undiluted and with ethylenediamine.

No immunological assay.

Clinical history.

INRS 2000 DMT 82 TR 25 page 153 Rosenberg N
Clin. Exp. Allergy 1998,28:358 - Piipari R. et al.
Clin. Exp. Allergy 1995,25:423
Allergy 1994,49:877
Br. J. Ind. Med.1992,49:294
J. Allergy, 1983,34:374
Clin. Allergy. 1980,10:263
Am. Rev. Resp. Dis. 1977,115:867
Clin. Allergy 1977,7:1
Clin. Allergy. 1972,2:189

1. [Medline] INRS 2000 DMT 82 TR 25 page 153 Rosenberg N  http://www.inrs.fr/produits/revues/dmt82.htm 

2. [Medline] Piipari R, Tuppurainen M, Tuomi T, Mantyla L, Henriks-Eckerman ML, Keskinen H, Nordman H.
   Diethanolamine-induced occupational asthma, a case report. Clin Exp Allergy. 1998 Mar;28(3):358-62. PMID: 9543086 

3. [Medline] 

Jobs/Métiers

Dyeing industry, Furrier, Organic chemistry industry, Pharmaceutical industry, Rubber industry

1-5 Naphtylene diisocyanate, Paraphenylenediamine

Incidence: very low incidence now. Asthmatic subjects are frequently atopic (IgE-dependent mechanism).

The hydroxyl, halide, nitro and sulphated derivatives are toxic. There is a danger of cancer of the bladder and methemoglobinemia.

Rhinitis and asthma associated with eczema may be present if the exposure to the risk has taken place over the long term.

Diagnostic

Bronchial provocation tests (in Hospital) by inhalation: aqueous solution 3% as an aerosol.

Skin patch tests in the case of eczema.

• J. Allergy, 1959,30:11

• J. Allergy, 1945,17:209;

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• [Medline]

Jobs/Métiers

Adhesives industry, Chemical industry, Dyeing industry, Electrical component manufacture, Epoxy resin industry, Food packer, Pharmaceutical industry, Plastics industry

Hexahydrophthalic anhydride HHPA, Himic anhydride, Maleic anhydride, Phthalic anhydride, Pyromellitic anhydride, Tetrachlorophtalic anhydride TCPA, Trimethyl anhydride

Incidence: the incidence of sensitisation depends on the nature of the product concerned: TCPA 15%, TMA 20%, HHPA 69%. PA is widely used throughout the plastics and pharmaceutical industries. TCPA and HHPA are used as hardening agents in the polymers industry. Asthma caused by HA has been reported in the production of fire retardant materials and products. Atopy does not play an important role. There is sometimes an IgE type sensitisation, but in addition to any immunological mechanism the substances are toxic and cause irritation which may give rise to RADS (Reactive airways dysfunction syndrome or asthma caused by irritants- Brook´s Syndrome). The continuation of symptoms after allergen avoidance is due to auto antibodies. Sensitisation to anhydrides significantly increases the risk of developing bronchial hyperreactivity.

Acid anhydrides are used as hardening agents for resins. They are released when polyvinyls compounds are melted. Mixture of anhydride powders may be dangerous.

Haemorrhagic rhinitis like asthma appears after a long period of exposure to the risk (greater than 10 years). Eye and skin problems may also occur. An influenza-like syndrome is sometimes observed with myalgia, fever and arthralgia (TMA). During periods of exposure to high concentrations of TMA, serious dyspnoea with haemoptysis and an infiltrate may be observed (toxic reaction). A recent study has shown that despite allergen avoidance, respiratory function remains disturbed even after 12 years.

Diagnostic

Skin prick test with the sodium salt of TMA-HSA (1:200) 3.4 mg/ml. In a cohort of 370 subjects, only 3% of skin tests were positive.

Immunological assay: PTRIA with TMA-HSA; RAST/CAP RAST for PA and TMA.

Bronchial provocation test (in hospital). Similarly for HHH-HSA, a positive skin prick test is a strong indicator of the likehood of the onset of asthma.

Eur. Respir. J. 2000,15:710 Baker R.D. et al.
J. Allergy. Clin. Immunol.1998,101:717 - Barker R.D. et al.
J. Lab. Clin. Med. 1996,127(5):443
Int. Arch. Occup. Environ Health 1995,67:395
Allergy 1993,48:627
Br. J. Med. 1991,48:643
Fiche All. Resp. Prof. INRS n°10
Ann. Inter. Med. 1983,98:8
Br. J. Ind. Med. 1989,46(4):222
Clin. Allergy 1980,10:263
J. Allergy. Clin. Immunol. 1990,85:55
J. Allergy. Clin. Immunol. 1987,80:212
J. Allergy. Clin. Immunol. 1987,80:223;
J. Allergy. Clin. Immunol. 1986,77:834 ;
J. Allergy. Clin. Immunol. 1985,75:663;
J. Allergy. Clin. Immunol. 1982,69:311;

1. [Medline] Barker RD, van Tongeren MJ, Harris JM, Gardiner K, Venables KM, Newman Taylor AJ.
   Risk factors for bronchial hyperresponsiveness in workers exposed to acid anhydrides.
   Eur Respir J. 2000 Apr;15(4):710-5. PMID: 10780763

2. [Medline] Barker RD, Harris JM, Welch JA, Venables KM, Newman Taylor AJ.
   Occupational asthma caused by tetrachlorophthalic anhydride: a 12-year follow-up. J Allergy Clin Immunol. 1998 Jun;101(6 Pt 1):717-9. No abstract available. PMID: 9648696

Jobs/Métiers

Animal breeder, Biologist, Pet shop employee, Pharmaceutical industry, Veterinary surgeon

Birds, Bovine dander, Cat, Crab, Deer, Dog, Fish based glues, Guinea pig, Hamster, Mink, Mouse, Rabbit, Rat, Rodents, Shellfish

Incidence: 10-32% of exposed subjects. Symptoms may appear between one month and one year after initial exposure to the risk; they are closely associated with the work place and disappear after the subject is removed from the contaminated environment-at least during the initial period. Various immunological mechanisms could be involved: IgE (rat urine); IgG in extrinsic alveolitis (extracts of animal organs). Investigation of work place conditions and possible preventative measures are very important. Studies at the workplace and prevention are very important. The technicians and personnel who clean out cages (especially rats) experience the greatest exposure. There is partial cross-reactivity between cow dander, cow's milk and beef..

The origin of the allergen depends on the animal in question: salivary proteins (cat); urinary proteins (rat); fur and urine proteins (Guinea Pig); pituitary gland extract (pig); dander and urine (cow) for which the antigen fractions have recently been described ; serum proteins (salmon farming; urinary proteins during the breeding season (mink).. Once asthma has been diagnosed, the severity of symptoms is directly related to the quantity of allergens in the environment. (Immuno-assay techniques such as ELISA may be used: 460 ? 300 ng/m3 of air for bovine dander)

Rhinitis, conjunctivitis and asthma are the most common symptoms. Contact urticaria is a fairly frequent symptom. Hyperthermia and fever may also occur in the case of alveolitis.

Diagnostic

Skin tests: skin prick test or IDR following allergen challenge. Bronchial provocation test (in Hospital).

Immunological essay. CAP or RAST: rat, mouse, hamster, guinea pig, rabbit, cat, dog; ELISA.

Ann. Allergy Asthma Immunol 1996,76:423 - Dong-Ho Nahm et al.
Allergy 1996,51(5):364 - Jimenez Gomez I. et al.
Allergol. et Immunopathol. 1997,25:259 - Valero Santiago A.L.
Clin. Exp. Allergy 1997,27:617 - Hollander A. et al.
Am. J. Respir. Crit. Care Med. 1995,151:640
Lancet 1995,346:737
J. Allergy Clin. Immun. 1989,84:520
J. Allergy Clin. Immun. 1985,76:724
Clin. Allergy 1988,18:95
Allergy 1988,43:483
Br. J. Ind. Med. 1988,45:667
Br. J. Ind. Med. 1988,45:660
Br. J. Ind. Med. 1987,44:672
Eur. Jour. Resp. Dis. (Suppl) 1982,123:60
J. Occup. Med. 1974,16:465

1. [Medline] Jimenez Gomez I, Anton E, Picans I, Jerez J, Obispo T.
   Occupational asthma caused by mink urine.  Allergy. 1996 May;51(5):364-5. No abstract available.
   PMID: 8836348

2. [Medline] Nahm DH, Park JW, Hong CS.
   Occupational asthma due to deer dander. Ann Allergy Asthma Immunol. 1996 May;76(5):423-6. PMID: 8630715

3. [Medline] Valero Santiago AL, Rosell Vives E, Lluch Perez M, Sancho Gomez J, Piulats Xanco J, Malet Casajuana A.
   Occupational allergy caused by cow dander: detection and identification of the allergenic fractions.
   Allergol Immunopathol (Madr). 1997 Nov-Dec;25(6):259-65. PMID: 9469201 

4. [Medline] Hollander A, Van Run P, Spithoven J, Heederik D, Doekes G.
   Exposure of laboratory animal workers to airborne rat and mouse urinary allergens. Clin Exp Allergy. 1997 Jun;27(6):617-26. PMID: 9208181

Jobs/Métiers

Agronomist,Baker, Cheese maker, Docker, Entomologist, Farmer, Food industry, Insect breeding, Laboratory staff, Manure spreader, Service personnel, Silage worker, Sericultur, Silk manufacture

Arthropods, Bombyx, Cockroach, Colorado beetle, Coleoptera, Dictyoptere, mite, Hymenoptera, Lepidoptera, Locust, Orthoptere, Phrygane, Shellfish, Silk worm, Weevil

Incidence: 10-15% for exposed subjects. With the exception of the pesticide industry and laboratories directly concerned with insects, the risk is directly related to the health and hygiene precautions employed.

The allergens involved are usually the glycoproteins of the cuticles, blood lymph system or excreta.

The immunological mechanism is the type 1 (IgE) class in the case of asthma.

Atopy is frequently encountered, but in other cases all the immune response reactions may occur.

Exposure to risk is either unintentional (nuisance), or through professional activities: animal (insect) breeding, preparation of local pesticide compounds. Nowadays, cases of asthma and rhinitis occur in the breeding of arthropods used for biological purposes.

Asthma appears 1 to 2 years after initial exposure to the risk. It is associated with working habits, at least at the outset.

Diagnostic

Skin tests: IDR or skin prick tests depending on the type of allergen. Immunological assays can be used (e.g. : house dust mite, grain weevil) for RAST/CAP RAST. A bronchial provocation test (in hospital) and a medical history are definitive.

Int. Arch. Occup. Environ Health 1996,68:133
J. Allergy Clin. Immunol. 1990,86:182
J. Allergy Clin. Immunol. 1989,84:296;
J. Allergy Clin. Immunol. 1984,74:261;
Clin. Allergy (A)1980,10:346;
Lancet 1980,1350;
Rev. Fr. Allergol. 1978,18(n°1):19,1;
Rev. Fr. Allergol. 1977,17(n°5):235;

• [Medline]
• [Medline]

Jobs/Métiers

Plastics industry, Rubber industry

Azodicarbonamide, Diazonium, Tetrafluoroborate

Incidence: almost 20% amongst exposed subjects. The product itself (rather than one of the pyrolysis gases) may be the agent responsible for the problems associated with the synthesis of poly-vinyl chlorides and polyolefins.

Atopic subjects are not at an increased risk of sensitisation. An immunological mechanism is suspected.

The compound, in the form of either a powder or a gas (380¡C), is used to inflate expanded plastic materials (packaging industry).

Conjunctivitis, rhinitis, cough, breathing difficulties and asthma may appear after several months of exposure. The clinical symptoms may become permanent and may be associated with a severe bronchial hyperreactivity.

Diagnostic

Skin prick test: 0.1, 1 and 5% azodicarbonamide.

Bronchial provocation test (in hospital): 15 seconds of exposure to a 50:50 mixture of lactose and azodicarbonamide.

Work place monitoring.

Br. J. Ind. Med. 1989,46:60
Am. J. Ind. Med. 1987,11:83;
Clin. Allergy 1985,15:261;
Thorax 1981,36:906;
J. Allergy. Clin. Immunol. 1980,85:1076;

• [Medline]
• [Medline]

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