Bronchial asthma and COPD due to irritants in the workplace - an evidence-based approach

Baur, Xaver; Bakehe, Prudence; Vellguth, Henning

doi:10.1186/1745-6673-7-19

Cited by 88 publications

(78 citation statements)

References 519 publications

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“…Noteworthy, distinguishing the phenotypes of IIA according to the characteristics or the intensity of irritant exposure (e.g. relative to permissible exposure limits) (17), is somewhat arbitrary since estimation of the exposure intensity has been most often qualitative, based on history and experience, and not on measurements of actual levels of irritant compounds generated during inhalation accidents.…”

Section: Clinical Phenotypes Of Irritant-induced Asthmamentioning

confidence: 99%

EAACI position paper: irritant‐induced asthma

Vandenplas

Wiszniewska

Raulf

et al. 2014

Allergy

125

108

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The term irritant-induced (occupational) asthma (IIA) has been used to denote various clinical forms of asthma related to irritant exposure at work. The causal relationship between irritant exposure(s) and the development of asthma can be substantiated by the temporal association between the onset of asthma symptoms and a single or multiple high-level exposure(s) to irritants, whereas this relationship can only be inferred from epidemiological data for workers chronically exposed to moderate levels of irritants. Accordingly, the following clinical phenotypes should be distinguished within the wide spectrum of irritant-related asthma: (i) definite IIA, that is acute-onset IIA characterized by the rapid onset of asthma within a few hours after a single exposure to very high levels of irritant substances; (ii) probable IIA, that is asthma that develops in workers with multiple symptomatic high-level exposures to irritants; and (iii) possible IIA, that is asthma occurring with a delayed-onset after chronic exposure to moderate levels of irritants. This document prepared by a panel of experts summarizes our current knowledge on the diagnostic approach, epidemiology, pathophysiology, and management of the various phenotypes of IIA.Abbreviations IIA, irritant-induced asthma; NSBH, nonspecific bronchial hyperresponsiveness; OA, occupational asthma; RADS, reactive airways dysfunction syndrome; TRP, transient receptor potential.

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Section: Clinical Phenotypes Of Irritant-induced Asthmamentioning

confidence: 99%

EAACI position paper: irritant‐induced asthma

Vandenplas

Wiszniewska

Raulf

et al. 2014

Allergy

125

108

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“…During these dissection classes, medical and dental students are exposed to formaldehyde vapors emitted from cadavers [3,4]. Inhalation is considered to be the primary route of exposure; however, the area of formalin absorbance includes the lungs, gastrointestinal tract, and skin [13,14]. Several reports have evidenced that formalin inhibits learning and hinders memory abilities in mice [15,16].…”

mentioning

confidence: 99%

Formaldehyde-related clinical symptoms reported by medical students during gross anatomy cadaver dissection

Pietrzyk¹,

Torres²,

Denisow-Pietrzyk³

et al. 2016

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Introduction. Formaldehyde is a noxious gas used as a tissue preservative of cadavers in autopsy rooms. Therefore, exposure to higher concentrations applies particularly to laboratory staff, anatomists and medical students. Prolonged exposure to formaldehyde is associated with clinical complications. Objective. To assess whether exposure to repeated inhalation of low concentrations of formaldehyde (FA) experienced during a gross anatomy course triggers subjective clinical symptoms in medical students. Material and methods. All 198 first-year medical students of the Medical University of Lublin, Poland (28% with allergy history and 72% without allergy history; 69% male and 31% female) responded to a questionnaire concerning their subjective FA-related clinical symptoms. Differences in proportions of experienced symptoms between allergic vs. nonallergic, and female vs. males were compared by the Mann-Whitney U test. Results. Even though formaldehyde concentrations in the gross anatomy laboratory were relatively low (0.47-0.57 mg/m 3 ), medical students experienced various reactions (lacrimation in 85.9%, red eyes, dry and itchy eyes, runny nose, sneezing, and headache in > 50% of students, cough in 44%, and dry throat or throat irritation in 42% of students). Among students with a history of allergy, eye, nose, skin and respiratory system symptoms occurred more frequently in comparison to nonallergic students. Female individuals demonstrated higher sensitivity to FA exposure. Conclusions. Exposure to formaldehyde may result in development of clinical symptoms in medical students. Particularly unpleasant symptoms may be experienced by individuals with allergy history. It is necessary to decrease formaldehyde concentrations in the anatomy dissection laboratory. streszczenie Wprowadzenie. Formaldehyd to szkodliwa substancja chemiczna, której wodny roztwór jest powszechnie stosowany jako środek konserwujący w prosektoriach anatomicznych. Osobami szczególnie narażo-nymi na ekspozycję na formaldehyd są studenci medycyny oraz perFormaldehyde-related clinical symptoms reported by medical students during gross anatomy cadaver dissection subiektywne objawy kliniczne u studentów medycyny związane z ekspozycją na formaldehyd podczas zajęć prosektoryjnych z anatomii

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“…In a study published in 2012, Baur et al [21] reviewed accessible literature concerning the incidence of irritating compounds responsible for the development of occupational asthma in work environments, as well as factors favoring the development of this disease. In 474 papers, authors detailed 188 factors (chemical compounds, professions, activities) causally associated with the development of occupational asthma.…”

Section: Discussionmentioning

confidence: 99%

Occupational exposure to selected isocyanates in Polish industry

Brzeźnicki¹,

Bonczarowska²

2015

Med Pr

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Funding / Finansowanie: within the project IMP 4.8 titled "Evaluation of reliability of selected isocyanates determinations in the air of workplace based on the biological monitoring of their metabolites eliminated with urine. " Project coordinator: Sławomir Brzeźnicki, Ph.D.http://dx.doi.org/10.13075/mp.5893.00020 AbstractBackground: Isocyanates constitute a group of highly reactive, low molecular weight chemicals used worldwide for polyurethane manufacturing. The occupational exposure to these compounds is a major cause of occupational asthma, thus it is very important to monitor their concentration in the workplace atmosphere. The aim of the study was to measure the concentration of 4,4'-methylenediphenyl diisocyanate (MDI; CAS 101-68-8), toluene-2,4-di-isocyanate (2,4-TDI; CAS 584-84-9), toluene-2,6-di-isocyanate (2,6-TDI; CAS 91-08-7) and hexamethylene di-isocyanate (HDI; CAS 822-06-0) in the work environment for evaluation of the occupational exposure to these compounds. Material and Methods: Determination of concentrations of selected isocyanates was carried out in 21 manufacturing plants, during different industrial processes. The collected air samples (personal samples) were analyzed by means of the high-performance liquid chromatography (HPLC). Results: The presented results represent the 1st data on the occupational exposure to isocyanates in Poland. This set of data is generally indicative of concentrations of analyzed isocyanates that are low and do not exceed the maximum admissible concentration (MAC) values in Poland. Elevated concentrations (above the MAC value) were found only for the TDI in the course of manufacturing of polyurethane foam blocks. Conclusions: Results of many studies show that low concentrations of isocyanates (particularly of low volatility like for example MDI) in the air cannot exclude the possibility of additional absorption of these compounds through skin. Taking into consideration all the uncertainties associated with the evaluation of the risk of exposure to isocyanates based solely on measurement of their levels in the air, it would seem that the simultaneous application of environmental and biological monitoring would only facilitate a reliable assessment of the occupational exposure risk. Med Pr 2015;66(3):291-301

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Bronchial asthma and COPD due to irritants in the workplace - an evidence-based approach

Cited by 88 publications

References 519 publications

EAACI position paper: irritant‐induced asthma

EAACI position paper: irritant‐induced asthma

Formaldehyde-related clinical symptoms reported by medical students during gross anatomy cadaver dissection

Occupational exposure to selected isocyanates in Polish industry

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