1/29. Report of occupational asthma due to phytase and beta-glucanase.OBJECTIVES: Occupational asthma is the principal cause of respiratory disease in the workplace. The enzymes phytase and beta-glucanase are used in the agricultural industry to optimise the nutritional value of animal feeds. A relation between these enzymes and occupational asthma in a 43 year old man was suspected. methods: inhalation challenge tests were performed with the enzymes phytase, beta-glucanase, and amylase. Skin prick tests were performed with the enzymes diluted to a concentration of 1 mg/ml and 5 mg/ml. Specific IgE to phytase and beta-glucanase were measured with a radioallergosorbent test. RESULTS: Baseline spirometry values were normal. A histamine challenge test showed bronchial hyperreactivity. Exposure to phytase and beta-glucanase led to significant reductions in forced vital capacity and forced expired volume in 1 second. No significant differences were noted after exposure to amylase. skin tests showed a positive reaction to beta-glucanase (5 mm) at a concentration of 1 mg/ml and positive reactions to beta-glucanase (7 mm) and phytase (5 mm) at a concentration of 5 mg/ml. Similarly specific IgE was present against both phytase and beta-glucanase, at 2.5% and 9.3% binding respectively (2% binding is considered positive). CONCLUSIONS: This is the first description of occupational asthma due to the enzymes phytase and beta-glucanase. Their addition to the ever increasing list of substances associated with occupational asthma will have notable implications for those exposed to these enzymes.- - - - - - - - - - ranking = 1keywords = bronchial hyperreactivity, hyperreactivity (Clic here for more details about this article) |
2/29. Reactive airways dysfunction syndrome caused by bromochlorodifluoromethane from fire extinguishers.Although the neurological and cardiovascular effects of Freons have been extensively described, the respiratory effects have been less well documented. We report four cases of occupational asthma following accidental exposure to bromochlorodifluoromethane (Halon 1211) due to release of the contents of a fire extinguisher. All subjects developed an irritative reaction of the upper airways and lower respiratory symptoms immediately after exposure. Non-specific bronchial hyperreactivity was present for at least two months in all subjects and was still present more than two years after exposure in one case. The diagnosis of reactive airways dysfunction syndrome can be adopted in at least three of these four cases.- - - - - - - - - - ranking = 1keywords = bronchial hyperreactivity, hyperreactivity (Clic here for more details about this article) |
3/29. Occupational asthma due to acrylates in a graphic arts worker.BACKGROUND: Acrylates are used in a wide variety of products such as solvents, adhesives, paints, printing ink, soft contact lenses, porcelain nails, and methacrylates (used by dentists and orthopedists). Currently there are various types of acrylic compounds: acrylates, cyanoacrylates (such as tissue adhesives and home glues), and methacrylates (prostheses and dental and orthopedic fillings). The sensitization mechanism is unknown, but the allergy is believed to be due to a non-IgE mediated phenomenon, since a late asthmatic response occurs. Various cases of acrylate-induced asthma have been reported, especially in dentists and persons using glues or paints containing this substance. MATERIAL AND methods: We present the case of a 52-year-old man who had been working in graphic arts for the previous 7 years. For the previous 2 years he had experienced persistent cough with a sensation of drowning, dyspnea that increased with moderate exertion, and nasal obstruction despite continuous treatment. The symptoms first appeared after an episode of acute respiratory difficulty associated with weight loss, pulmonary infiltrates, and eosinophilia. Peak expiratory flow (PEF) was measured during work and sick leave, and specific bronchial challenge with acrylates was performed in a bronchial chamber. RESULTS: The PEF improved on weekends and sick leave. The challenge test provoked a late asthmatic response and the non-specific bronchial hyperreactivity increased after the test. As well in the sputum samples there was a increase of eosinophil amount.- - - - - - - - - - ranking = 1keywords = bronchial hyperreactivity, hyperreactivity (Clic here for more details about this article) |
4/29. fever and respiratory symptoms after welding on painted steel.Electric-arc welding generates particles and gases that can induce chronic bronchitis and airway obstruction. In this case report two welders are described who had fever, spirometric deterioration, and bronchial hyperreactivity after welding steel painted with chloro-containing polymer lacquer. Pyrolysis of this paint releases many different compounds, for example, hydrogen chloride and complex chlorinated compounds.- - - - - - - - - - ranking = 1keywords = bronchial hyperreactivity, hyperreactivity (Clic here for more details about this article) |
5/29. Occupational asthma caused by brazil ginseng dust.The inhalation of different substances of plant origin can cause immediate and late onset asthma. The list of these agents responsible for such reactions is continuously increasing. We discuss a patient who developed symptoms of asthma after exposure to Pfaffia paniculata root powder used in the manufacturing of brazil ginseng capsules. Airway hyperreactivity was confirmed by a positive bronchial challenge to methacholine. Sensitivity to this dust was confirmed by immediate skin test reactivity, a positive bronchial challenge (immediate response), and the presence of specific IgE detected by ELISA technique to an aqueous extract. The bronchial response was inhibited by sodium cromoglycate. Unexposed subjects did not exhibit reactivity to this ginseng extract with any of the tests referred to above. The same study performed with Korean ginseng (panax ginseng) elicited negative results. This study is the first, to our knowledge, that links ginseng-root dust to occupational asthma.- - - - - - - - - - ranking = 0.38478574272971keywords = hyperreactivity (Clic here for more details about this article) |
6/29. Screening for occupational asthma: a word of caution.The diagnosis of occupational asthma may be difficult due to the complex mechanisms inducing the disorder. Identification of the offending agent after historical documentation may be difficult without bronchial challenge. The hallmark of asthma is bronchial hyperreactivity as detected by methacholine challenge, and this test could be considered as a screening test for asthma in the workplace. Four cases are presented that document changes in methacholine airway reactivity dependent on temporal association with exposure to the workplace or the specific offending agent. This indicates a need for a careful evaluation of symptoms relative to exposure in patients suspected for workplace asthma as well as serial determinations of methacholine response to detect potential variability in the airway reactivity.- - - - - - - - - - ranking = 1keywords = bronchial hyperreactivity, hyperreactivity (Clic here for more details about this article) |
7/29. Occupational asthma caused by exposure to neurospora in a plywood factory worker.A 24 year old man developed severe asthma two years after starting to work in a plywood plant. Four years later the patient had to stop working because of the increasing severity of his asthma. Three months after leaving his job, the patient's asthma was greatly improved. His job consisted of placing plywood sheets into a drying machine. The plywood sheets had stayed outside in wet conditions for at least four to six weeks and were usually covered with moulds. Drying the plywood sheets changed the mould into a fine orange powder. Exposure to this in the laboratory induced an isolated immediate asthmatic reaction. The same reaction was seen when the patient was challenged with an extract of the mould powder at a 0.1% w/v concentration. Skin prick test with the mould extract induced a weal and flare reaction and IgE antibodies against the dry mould powder were identified. A control patient with the same degree of bronchial hyperreactivity did not have any asthmatic reaction when challenged with the same mould extract. culture of the dry mould powder on Sabouraud agar plates grew pure neurospora sp. This mould has not been previously reported as a cause of occupational asthma. The immunological mechanism is probably related to an IgE mediated mast cell allergy.- - - - - - - - - - ranking = 1keywords = bronchial hyperreactivity, hyperreactivity (Clic here for more details about this article) |
8/29. Legal treatment of the asthmatic worker: a major problem for the nineties.Workers with pre-existing asthma that has become "aggravated" by stimuli in the workplace can be "disabled" in a legal sense. Should workers compensation be extended to provide disability benefits when the aggravating stimuli are ubiquitous, when the employment relationship was brief, when separation from the offending stimuli ends symptoms, or when hyperreactivity can be medically managed?- - - - - - - - - - ranking = 0.38478574272971keywords = hyperreactivity (Clic here for more details about this article) |
9/29. Persistent reactive airway dysfunction syndrome after exposure to toluene diisocyanate.Two police officers developed asthma like illness after a single but prolonged exposure to toluene diisocyanate (TDI) by being in the immediate vicinity of a tank car that had overturned on a highway. One officer experienced upper and lower respiratory tract symptoms with chest tightness about 4.5 hours after initial exposure. Shortness of breath, cough, and wheezing were noted the following day. The other experienced symptoms immediately on exposure, developed shortness of breath 20 minutes later, and presented with wheezing four hours after that. Follow up examinations over seven years showed persistence of respiratory symptoms and continuation of airway hyperreactivity requiring treatment.- - - - - - - - - - ranking = 0.38478574272971keywords = hyperreactivity (Clic here for more details about this article) |
10/29. Late asthmatic reaction in a hairdresser, due to the inhalation of ammonium persulphate salts.Persulphate salts are among the various chemical substances that can cause occupational diseases in hairdressers. We present the case of a 21 year-old female who worked in a hairdressing salon for five and a half years. Five years prior to consultation, she presented with rhinitic symptoms and wheezing dyspnea which were related with her working environment. The routine laboratory examinations carried out on the patient were found to be normal. Among the various allergic exams performed there was an elevated total IgE. The provocation test with histamine was positive at the concentration of 10 mg/ml, demonstrating mild bronchial hyperreactivity. The test of bronchial exposure to ammonium persulphate was positive with bronchospasm 3-4 hours after this test. With a prior inhalation of betamethasone we were able to block this reaction, but with disodium cromoglycate we were able to block it only partially. We conclude that the patient presented with late onset bronchial asthma due to sensitivity to ammonium persulphate. It has to be pointed out that this patient was a rare case as generally persulphate salts choose to invade and affect the skin. The rarity of this pathology is reflected by the scarce bibliography on this subject.- - - - - - - - - - ranking = 1keywords = bronchial hyperreactivity, hyperreactivity (Clic here for more details about this article) |
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