Allergy risk in an enzyme producing plant: a retrospective follow up study.

Abstract

Objective-To investigate the risk of enzyme sensitisation and clinical allergy in workers exposed to enzymes at Novo Nordisk A/S. Methods-The study was a retrospective follow up study based on medical history and test data originally collected at routine screenings for enzyme allergy by the Occupational Health Service (OHS) of Novo Nordisk AMS during the period 1970-92. Workers were exposed to proteases, lipases, cellulases, and carboxyhydrases. Medical records of 3815 subjects were registered in the OHS database. According to criteria including possible enzyme exposure, allergy tests at the time of engagement, and participation in the allergy screening programme 1064 were selected for the present study. Outcomes were allergy symptoms, specific IgE test (radioallergosorbent test (RAST)) to enzymes, skin test reactions to common allergens and enzymes, forced expiratory volume in one second (FEV,), and forced vital capacity (FVC). Potential risk factors were smoking habits, workplace, type of job, age, and sex. Results-Sensitisation occurred to all types of enzymes handled in the plant, most often in production areas and laboratories; 8.8% developed clinical enzyme allergy during the first three years of employment. The risk declined during the period. The frequency of enzyme sensitisation, expressed as RAST values > 0.5 SU, was 36%, and the frequency of significant RAST values > 2 SU was 8%. Ranking diagnoses of enzyme allergy by severity, the frequency ofasthma was 5.3%, rhinitis 3.0%, and urticaria 0.6%. Half of the cases occurred within the first 15 months of exposure. Smoking was an independent risk factor for clinical enzyme allergy (odds ratio (OR)=2.3 (95% exact confidence interval (95% CI) 1.4 to 3.9), measurable RAST ¢0.5 SU (OR=1.5 (95% CI 1.1 to 2.1)), and RAST 2 SU (OR=4.5 (95% CI 2.2 to 8.4)). Atopic predisposition at the time of engagement was not a significant risk factor for enzyme allergy. This could be due to various selection mechanisms.(Occup Environ Med 1997;54:671-675)

Genetic Polymorphisms of ADRB2 and IL10 May Be Associated with the Risk of IgE Sensitization to Digestive Powders in Exposed Medical Personnel

“…Some studies have reported that atopy is a risk factor of sensitization to enzymes [1,25], whereas others have concluded that it is not a significant risk factor [21,26]. In the present study, serum total IgE levels were found to be significantly associated with the presence of a powder allergy among exposed subjects, but no significant association was found between atopy and working duration in exposed medical personnel with an allergic reaction.…”

Enzymes as occupational and environmental respiratory sensitisers

“…Hor v 17 (b-amylase) that 5% had work-related asthma and 3% rhino-conjunctivitis; IgE-mediated sensitisation mainly occurred to subtilisin, glycoamylase and/or trypsins (Johnsen et al 1997). Among 29 cooks in an industrial kitchen where a papain-containing meat-tenderiser was used, ten (34.5%) were sensitised and 50% reported respiratory and/or conjunctival hypersensitivity symptoms (Baur et al 1982).…”

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…Many other high-molecular-weight allergens can induce IgE-mediated rhinitis and asthma: agricultural mites (339-342, 347, 348, 350, 351), coffee beans (598), proteolytic enzymes (515,599,600), other enzymes (601,602), insect dust (577); plants and flowers (603,604).…”