Occupational airway sensitizers: an overview on the respective literature

Abstract

Background Worldwide, there is rigorous scientific activity concerning the further development of work safety regulations involving airway‐sensitizing substances. Technical directives on hazardous substances are enforced in several countries and are being continuously updated. The European Union has established a code for several occupational substances, now labeled R 42 (“may cause sensitization by inhalation”). Methods We present an overview of the literature dealing with allergic occupational asthma. The literature was selected according to criteria of study design and diagnostic test methods. Approximately 300 publications were reviewed including both epidemiological studies and individual case reports. Results Airway sensitizers are systematically arranged and separately listed according to chemicals and their origin from animals, plants, and microorganisms. The clinical data as well as threshold limit values (TLV) and R 42 labeling of 250 airway‐sensitizing substances are presented. Conclusions The most common sensitizing substances causing occupational asthma were dust of cereal flours, enzymes, natural rubber latex, laboratory animals as well as low molecular substances such as isocyanates and acid anhydrides. Am. J. Ind. Med. 38:164–218, 2000. © 2000 Wiley‐Liss, Inc.

Asthma characteristics in cleaning workers, workers in other risk jobs and office workers

“…Those exposed to low MW agents were painters, hairdressers, and metal, wood, plastics and rubber workers. Most of these agents cause asthma through IgE-independent mechanisms [17]. Excluded from these two groups were workers who reported a previous job in cleaning.…”

Work-related asthma and implications for the general public.

“…Over 350 chemicals, mixtures, and processes found in the workplace have been associated with the onset or exacerbation of asthma, with over 250 documented as airway sensitizers (14,15). Recent studies implicate workplace exposures in an important proportion of cases of new-onset asthma among adults, and exposures to agents in the workplace that result in the onset of asthma continue to be described (16,17).…”

Acute Expanded Perlite Exposure with Persistent Reactive Airway Dysfunction Syndrome

“…The three symptomatic workers who become airway hyper-reactiveness (AHR) have no previous exposure to sensitizers 5) in their workplace before this incident. Nevertheless, as shown in the literature RADS usually occurs to corrosive or irritating gas, vapor, fume or dust 6) exposure, and thus it is also categorized as irritant induced occupational asthma 7) , while perlite had never been recognized in the above list, either as an irritant 6) or a sensitizer 8) . The remaining perlite powder on the ground was analyzed and it showed some Cr, As, Cd, Hg (<5 ppm) and Pb (80 ± 5 ppm).…”