SOMMAIRE

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14-Mar-2006

Métiers/Occupation/Jobs

Substances/Agents

Medical personnel, Nurse, Pharmaceutical industry

Ispaghule, Pysllium

Incidence

Conditions

Symptom

Incidence: 3.6 to 27.9% of subjects working in the factory. However, there is a lower incidence for those working in health care.

Atopy plays an important role.

IgE-dependent mechanism.

Certain researchers report a cross reactivity with the common plantain. The use of psyllium as a pill rather than a powder has reduced the number of cases under medical care.

Pysllium is a popular laxative. The allergen is obtained from plantain (plantago ovata). It is also known as ispaghula..

Asthma, conjunctivitis, urticaria and angio-oedema. In the case of ingestion by a sensitized subject generalised anaphylactic reaction may occur as well as asthma.

Diagnostic

References

Skin prick test and immunological assay RAST/CAP RAST. A bronchial provocation test (in Hospital) may be dangerous but is definitive

Am. Rev. Resp. Dis. 1990,142:1359
J. Occ. Med. 1987,29:497
Lancet 1985,8435:965
Clin. Allergy 1987,71:1
Am. Rev. Respir. Dis. 1987,135:1033
Allergy Copenh. 1979,34:51
Ann. Allergy 1982,48:294
Allergy 1984,39:65
Allergy 1983,38:363
Allergy 1983,38:141

1. [Medline]  Malo JL, Cartier A, L'Archeveque J, Ghezzo H, Lagier F, Trudeau C, Dolovich J.
   Prevalence of occupational asthma and immunologic sensitization to psyllium among health personnel in chronic care hospitals. Am Rev Respir Dis. 1990 Dec;142(6 Pt 1):1359-66. PMID: 2252254

2. [Medline] [No authors listed]
   Smoking, occupation, and allergic lung disease. Lancet. 1985 Apr 27;1(8435):965. No abstract available. PMID: 2859419

Métiers/Occupation/Jobs

Substances/Agents

Fireman, Food packaging industry, Plastic bottle/bottling industry

Diocetyl phtalate, Phthalic anhydride, PVC

Incidence

Conditions

Symptom

Incidence: much greater amongst smokers. IgE-dependent mechanism.

In firemen exposed to large quantities of PVC combustion products, RADS (Reactive airways dysfunction syndrome or asthma caused by irritants – Brooks syndrome) may occur. The long term effects may involve chronic bronchitis. Smoking is clearly an aggravating factor.

Heat-sealing of plastic packaging materials (e.g. in food packaging).

The pathology is also known under the name of meat packer's illness.

Production line work in the manufacture of plastic bottles

Cough, expectoration and asthma symptoms initially associated with work then becoming persistent elsewhere. Rhinitis and irritative conjunctivitis with headache. Possibility of acute asthma.

Diagnostic

References

Skin prick test or IDR with PA-HSA; scratch test 6.8x10-3 mol/l.

Immunological assay: PTRIA with PA-HSA or PA-BSA, RAST/CAP RAST with phthalic anhydride.

Bronchial provocation test (in Hospital).

INRS 2000 DMT 82 TR 25 page 153 Rosenberg N
Med. Lav. 1999,90:513 - Cipolla C. et al.
Arch. Environ. Health 1989,44:30
A. J. Ind. Med. 1988,14:273
Am. Rev. Resp. Dis. 1976,113:701
J. Allergy Clin. Immunol.1982,69:311

• [Medline] Cipolla C, Belisario A, Sassi C, Auletti G, Nobile M, Raffi GB.
  Occupational asthma caused by dioctyl-phthalate in a bottle cap production worker.
  Med Lav. 1999 May-Jun;90(3):513-8. Italian.  PMID: 10434532  

Métiers/Occupation/Jobs

Substances/Agents

Hairdresser, Sericulture, Textile industry

Sericin

Incidence

Conditions

Symptom

Incidence: in the sericulture industry more than 50% of subjects are affected. In 1965 there was an outbreak of an asthma epidemic amongst hairdressers.

Atopy does play a role, however all exposed subjects may become affected.

IgE-dependent mechanism.

Work place conditions in the factory and the presence of other allergens in the hairdressing salon increase the symptoms. The possibility of pulmonary thesaurisoma should be considered since modern lacquers contain polyvinylpyrolidone.

Sensitization occurring due to the preparation of the cocoon and unwinding processes in the silk industry.

In the case of the hairdresser, the hair lacquer spray contains sericin

Asthma,rhinitis and urticaria.

Diagnostic

References

Skin prick test (allergen extract is not commercially available).

Bronchial provocation test (in Hospital) and work place monitoring.

Immunological assay: RAST sericin.

Toxicol. 1963,1:171
Thorax 1986,41:42
Rev. Fr. Allergol.1967,4:193

• [Medline]  Blainey AD, Ollier S, Cundell D, Smith RE, Davies RJ.
  Occupational asthma in a hairdressing salon.
  Thorax. 1986 Jan;41(1):42-50.   PMID: 3704965

Métiers/Occupation/Jobs

Substances/Agents

Docker, Farmer, Food industry

Soya

Incidence

Conditions

Symptom

Incidence: low, but there have been asthma epidemics following unloading of soya cargoes, notably in Barcelona, Spain, which affected the populace of the town and its' surroundings. IgE-dependent mechanism. Atopy is a less important predisposing factor than bronchial hyperreactivity.

Sensitization of workers in the food industry is well known; sensitization is less common amongst harbour workers and the general public, but is known. Sensitisation to soybean dust is different to sensitisation to soya flour. Some allergens are common whilst others are restricted to vegetal debris. The allergen involved in asthma epidemics due to soya is usually gly m1 whilst that of soya flour is gly m2.

Asthma and dyspenoea symptoms occurring towards the end of the working day may continue for several hours after work. Serious rhinitis.

Diagnostic

References

Skin prick test.

Immunological assay: RAST/CAP RAST soya. Gly m1 can be measured using ELISA.

Bronchial provocation test (in Hospital).

Int. Arch. Allergy Immunol. 1999,119:69 Codinar et al.
Clin. Exp. Allergy 2000,30:839 Quirce S. et al.
J. Allergy Clin. Immunol. 1988,81:264 (Abstract)
J. Allergy Clin. Immunol. 1988,82:25
N. Engl. J. Med. 1989,320:1997
Lancet 1989,1:179
Lancet 1986,1:900
Clin. Allergy 1977,7:369

1. [Medline]  Codina R, Lockey RF, Fernandez-Caldas E, Rama R.
   Identification of the soybean hull allergens responsible for the Barcelona asthma outbreaks. Int Arch Allergy Immunol. 1999 May;119(1):69-71. PMID: 10341324 

2. [Medline]  Quirce S, Polo F, Figueredo E, Gonzalez R, Sastre J.
   Occupational asthma caused by soybean flour in bakers--differences with soybean-induced epidemic asthma. Clin Exp Allergy. 2000 Jun;30(6):839-46. PMID: 10848902 

3. [Medline]  Lachance P, Cartier A, Dolovich J, Malo JL.
   Occupational asthma from reactivity to an alkaline hydrolysis derivative of gluten. J Allergy Clin Immunol. 1988 Feb;81(2):385-90. PMID: 3339195

Métiers/Occupation/Jobs

Substances/Agents

Welder

Aluminium, Chromium, Nickel, Vanadium, Zinc

Incidence

Conditions

Symptom

An epidemiological study in 1995 in young apprenties showed that only 1% of exposed subjects exhibited symptoms after a 5 year follow-up. Incidence is much higher amongst smokers. IgE-dependent mechanism, however irritants play a role. Atopy is an aggravating factor. In addition to the asthmatic risk, there is also a carcinogenic risk (Ni, Cr). In other forms of welding, such as welding tin, cases of asthma caused by zinc chloride have been described. In the case of nickel, its oxides are the cause of the problem; for chromium the hexavalent and trivalent forms are responsible.

Sensitization is caused by fumes from the metals, chromium, nickel, cobalt, zinc, aluminium and vanadium. For example, asthma caused by zinc fumes has been reported in galvanization plants. The presence of argon, helium and/or carbon dioxide in the atmosphere gives rise to the production of oxygen free radicals. Vanadium oxide may also cause RADS (Reactive airways dysfunction syndrome or asthma caused by irritants – Brooks syndrome). . Deposits of epoxide resins on the metals also increase the risk of work-related respiratory problems.

Severe asthma developing into chronic obstructive bronchopathy. Early and late phase reactions occur.

Diagnostic

References

Skin prick test can be performed, but it is not reliable.

Immunological assay: subject of current research.

Bronchial provocation test (in Hospital).

INRS 2000 DMT 82 TR 25 page 153 Rosenberg N
Thorax 1997,52:28 - Bright P. et al.
Am. J. Respir. Crit. Care Med. 1996,154:1394 - Beach J.R. et al.
Thorax 1995,50:587
Eur. Resp. J. 1993,6:447
Thorax 1989,44:220
J. Allergy Clin. Immunol. 1983,72:407
Clin. Allergy 1980,10:151
Austr. Welding Res. Assoc VIII-755-77:741
Austr. Welding Res. Assoc. IIW/IIS
Int. Arch. Occup. Environ. Health 1985,56:111

• [Medline] Bright P, Burge PS, O'Hickey SP, Gannon PF, Robertson AS, Boran A.
  Occupational asthma due to chrome and nickel electroplating. Thorax. 1997 Jan;52(1):28-32. PMID: 9039236

• [Medline] Beach JR, Dennis JH, Avery AJ, Bromly CL, Ward RJ, Walters EH, Stenton SC, Hendrick DJ.
  An epidemiologic investigation of asthma in welders. Am J Respir Crit Care Med. 1996 Nov;154(5):1394-400. PMID: 8912754

Métiers/Occupation/Jobs

Substances/Agents

Farmer, Hospital staff, Service Personnel, Pharmaceutical industry, Water treatment industry

Chloramine t, Halazone, Tosylcloramide

Incidence

Conditions

Symptom

Incidence: increasing. Initially, the problem was restricted to those manufacturing the products, but now maintenance personnel are affected as well.

IgE-dependent mechanism.

The influence of atopy has not been discussed.

Sensitization occurring during water treatment or the manufacture of the chemicals. This sensitisation may also occur in all persons using these products.

Classic asthma. A case of hyperthermia associated with the asthma has been described. The possibility of RADS (reactive airways dysfunction syndrome, or asthma caused by irritants – Brook´s syndrome)exists.

Diagnostic

References

Skin prick test (allergen extract not commercially available).

Immunological assay: RAST/CAP RAST chloramine T.

Bronchial provocation test (in Hospital) produces both immediate and delayed reactions.

INRS 2000 DMT 82 TR 25 page 153 Rosenberg N
J. Allergy 1975,16:209
Lakartidningen 1989,86:4262
Clin. Exp. Allergy 1989,19:463
Med. Lav. 1988,79:237
Int. Arch. Allergy Appl. Immunol. 1981, 64:428
Int. Arch. Allergy Appl. Immunol. 1981,64:422

• [Medline]  Blomqvist A, Sundell L, Axelsson G.
  A patient with IGE-mediated allergy to chloramine T received occupational injury compensation.
  Lakartidningen. 1989 Nov 29;86(48):4262-4. Swedish. No abstract available. PMID: 2531824

• [Medline]  Wass U, Belin L, Eriksson NE.
  Immunological specificity of chloramine-T-induced IgE antibodies in serum from a sensitized worker.
  Clin Exp Allergy. 1989 Jul;19(4):463-71. PMID: 2758361

Métiers/Occupation/Jobs

Substances/Agents

Tobacco manufacturer

Tobacco leaves

Incidence

Conditions

Symptom

Incidence: unspecified. Very dry tobacco leaves are the most dangerous. Moulds such as Alternaria and Aspergillus can alter the symptoms (alveolitis). Subjects are not always atopic. IgE-dependent mechanism. Tobacco smoking plays an aggravating role.

Tobacco is a member of the Solanaceae family. Cross-reactivity may exist between the foodstuffs belonging to this family as well as to mugwort or armoise pollen.

Subjects become sensitized by the inhalation of dried tobacco leaf debris.

Rhinitis and asthma with tightness of the chest, acute, sometimes violent dyspnoea.

Contact urticaria has also been described.

Diagnostic

References

Skin prick test with a tobacco leaf extract.

Immunological assay: RAST/CAP RAST with tobacco leaf extract

Bronchial provocation test (in Hospital).

Am. Allergy Asthma Immunol. 1999,82:194 - Ortega N. et al.
Br. J. Ind. Med. 1986,43:802
N. Engl. J. Med. 1980,302:617

1. [Medline] Ortega N, Quiralte J, Blanco C, Castillo R, Alvarez MJ, Carrillo T.
   Tobacco allergy: demonstration of cross-reactivity with other members of Solanaceae family and mugwort pollen. Ann Allergy Asthma Immunol. 1999 Feb;82(2):194-7. PMID: 10071524 

2. [Medline] Viegi G, Paggiaro PL, Begliomini E, Vaghetti E, Paoletti P, Giuntini C.
   Respiratory effects of occupational exposure to tobacco dust. Br J Ind Med. 1986 Dec;43(12):802-8.  PMID: 3801331 

Métiers/Occupation/Jobs

Substances/Agents

Pharmaceutical industry

Tetracycline

Incidence

Conditions

Symptom

Incidence: only a few cases have been described.

The sensitization delay is always a few months.

Atopy does not play a role.

IgE-dependent mechanism.

Only the parent tetracycline molecule seems to cause symptoms.

Classic asthma. There is a risk of anaphylactic reactions and reactivation of symptoms if the drug is taken orally.

Diagnostic

References

Skin tests: IDR from 10-5 fold dilution up to the neat product with a 15 minute period between each test.

Bronchial provocation tests have not been reported, but may be of interest.

Clin. Allergy 1977, 7:285

• [Medline]  Menon MP, Das AK.
  Tetracycline asthma--a case report. Clin Allergy. 1977 May;7(3):285-90. PMID: 908126

Métiers/Occupation/Jobs

Substances/Agents

Clothing industry, Ironer, Spinning, Textile industry, Weaving

Cotton, Flax, Hemp, Jute, Kapok, Nylon, Orlon, Rayon, Silk, Sisal, Wool

Incidence

Conditions

Symptom

Incidence: dependent upon the quality of the working environment. In the case of asthma, the mechanism is IgE-dependent, but type III reactions may also occur. Some substances which act as bronchoconstrictors that act directly (endotoxins) may be encountered. Atopy appears to play a role in the case of asthma. Smoking and previous bronchial hyperreactivity aggravate the symptoms. The prevalence of this work-related asthma is around 6%.

Natural fibres have long been known to be responsible for allergic diseases. In 1961, the first cases of asthma and chronic bronchitis were described in employees working in nylon-producing factories. The raw materials are not the only problem: contaminants and products used in the treatment of the fibres can play a role (formol, dyes etc).

The clinical symptoms are numerous : rhinitis, dry eyes and throat, conjuntivitis and sinusitis. Classic asthma may occur and can be accompanied by chronic dyspenoea which develops into chronic obstructive bronchopathy and, in the case of flax, fibrosis (byssinosis). Longitudinal studies over 16 years show that ventilatory problems are significantly increased compared to controls (p<0.05).

Diagnostic

References

Skin prick test: extracts commercially available for a number of allergens extracted from natural fibres. Immunological assay: RAST/CAP RAST extracts similarly available. Bronchial provocation test using the raw material (in Hospital) for asthma.

Am. J. Ind. Med. 1998,33:263 - Zuskin E. et al.
Am. J. Ind. Med. 1997,31:344 - Zuskin E. et al.
Thorax 1975,30:204
"Pathologie professionnelle dans l'industrie des fibres artificielles" Paris Médecine du travail 1961.
Am. J. Ind. Med. 1988,14:187
Bull. Europ. Physiopath. Resp. 1979,115:455;
Wien. Klin. Wochenschr. 1987,99:542;
Br. Ind. Med. 1988,45:727;
Am. J. Pathol. 1988,133:163;
Ann. Allergy 1978,41:48;

1. [Medline] Zuskin E, Mustajbegovic J, Schachter EN, Kern J, Budak A, Godnic-Cvar J. Respiratory findings in synthetic textile workers. Am. J. Ind. Med 1998,33:263 - Zuskin E. et al.

2. [Medline] Zuskin E, Mustajbegovic J, Schachter EN, Doko-Jelinic J. Respiratory function of textile workers employed in dyeing cotton and wool fibers. Am. J. Ind. Med 1997,31:344 - Zuskin E. et al.

3. [Medline] Pimentel JC, Avila R, Lourenco AG.
   Respiratory disease caused by synthetic fibres: a new occupational disease. Thorax. 1975 Apr;30(2):204-19. PMID: 1179318

Métiers/Occupation/Jobs

Substances/Agents

Animal breeder, Docker, Oil-works employee, Perfumer

Ambrette, Castor oil (Ricin), Flax, Hibiscus abelmoschus, Oilcake, Peanut, Rapeseed oil (Colza)

Incidence

Conditions

Symptom

Incidence: between 3 and 5% of exposed subjects.

Atopic subjects seem to be predisposed towards the disease, however some non-atopic subjects are also affected.

IgE-dependent mechanism.

The allergen is a low molecular weight protein.

Contamination of work place and surrounding areas during processing. When castor oil cakes are used as "natural" fertilisers, a number of different professions may be affected including deliverymen, retailers, wholesalers etc... The volatile organic components of rapeseed can be irritative and/or allergenic. These rapeseed oilcake/cattle-cakes are used in the feeding of livestock. Cases of occupational asthma have recently been reported in animal breeders, demonstrating that moderate exposure, and even occasional exposure can give rise to true sensitisations.

Violent asthmatic attacks, epidemic, symptoms cease after contact with the causative agent. Attacks may be immediate or delayed. In the case of asthma caused by ambrette (Hibiscus Abel.) working with oilseed and powdered seeds also causes eczema.

Diagnostic

References

Skin prick test: 1/100 dilution for castor oil (not commercially available). Immunological assay: RAST/CAP RAST castor oil, peanut and rape seed.

IDR tests may induce lymphangitis.

Bronchial provocation tests (in Hospital) must be preceded and followed by a measure of bronchial hyperreactivity. The threshold for bronchial hyperreactivity is lowered following the bronchial provocation test. Eosinophil numbers are increased in induced sputum in cases of asthma induced by these allergens.

Allergy 2001,56:185 Alvarez MP.J. et al.
Clin. Exper. Allergy 1995,25:985
Allergy 1994,49:897
Rev. Fr. All. 1990,30,29:31
Int. Arch. Appl. Immun. 1987,82:456
Int. Arch. Appl. Immun. 1981,64:230
Allergy 1983,38:155
Clin. Allergy 1983,13:553
Clin. Allergy 1981,11:463
J. Allergy Clin. Immunol. 1990,85:778
Lancet 1989,1:179
Acta Allergol. 1959,14:150

1. [Medline]  Alvarez MJ, Estrada JL, Gozalo F, Fernandez-Rojo F, Barber D.
   Oilseed rape flour: another allergen causing occupational asthma among farmers.
   Allergy. 2001 Feb;56(2):185-8. PMID: 11167382

2. [Medline] Butcher RD, Goodman BA, Deighton N, Smith WH.
   Evaluation of the allergic/irritant potential of air pollutants: detection of proteins modified by volatile organic compounds from oilseed rape (Brassica napus ssp. oleifera) using electrospray ionization-mass spectrometry. Clin Exp Allergy. 1995 Oct;25(10):985-92. PMID: 8556570

3. [Medline] Merget R, Heger M, Wahl R, Cromwell O, Rasche K, Schultze-Werninghaus G.
   Seasonal occupational asthma in an agricultural products merchant--a case report. Allergy. 1994 Dec;49(10):897-901. PMID: 7710004 

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Date de création: 3 Février 1999    mise à jour 14-Mar-2006  
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