Exposure to an agent during diacetyl production appears to be responsible for causing bronchiolitis obliterans syndrome in chemical process operators, consistent with the suspected role of diacetyl in downstream food production.

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Objectives: To investigate sensitisation and respiratory health among workers who produce liquid detergent products and handle liquid detergent enzymes. Methods: We performed a cross-sectional study among 109 eligible workers of a detergent products plant. 108 were interviewed for respiratory and allergic symptoms and 106 blood samples were taken from them to examine sensitisation to enzymes. Those sensitised to >1 enzymes were referred for clinical evaluation. Workers and representatives were interviewed to characterise exposure qualitatively and estimate exposure semiquantitatively. Workers were classified into three exposure groups with varying exposure profiles to enzymes, based on frequency, duration, and level of exposure. Results: Workers were exposed to proteases, a-amylase, lipase and cellulase. The highest exposures occurred in the mixing area. Liquid spills with concentrated enzyme preparations and leakage of enzymes during weighing, transportation and filling were causing workplace contaminations and subsequently leading to both dermal and inhalation exposure for workers. Workers with the highest exposures reported significantly more work-related symptoms of itching nose (prevalence ratio (PR) = 4.2, 95% CI 1.5 to 12.0) and sneezing (PR = 4.0, 95% CI 1.5 to 10.8) and marginally significant more symptoms of wheezing (PR = 2.9, 95% CI 0.9 to 8.7) compared with the least exposed group. Fifteen workers (14.2%) were sensitised to >1 enzymes. A marginally statistically significant gradient in sensitisation across the exposure categories was found (p = 0.09). There was a clinical case of occupational asthma and two others with probable occupational rhinitis. Conclusions: Workers exposed to liquid detergent enzymes are at risk of developing sensitisation (14%) and respiratory allergy.Occupational asthma (OA) in the detergent industry was first reported in 1969 and associated with exposure to dust of proteolytic enzymes. Occupational allergies were considered to be under control as a result of encapsulation of enzymes and improved hygiene in the 1970s 3 4 and evidence exists for a reduction of OA risk.5 6 Despite these measures, sensitisation could not be totally prevented 4 and new outbreaks of OA have been reported due to detergent enzymes exposure. 7 8 This study was occasioned by the occupational health service of a liquid detergent production plant which, in a pilot study, reported that three out of 12 highly exposed workers were sensitised to detergent protease (Savinase).As far as we know, no occupational respiratory allergies have been reported in detergent production industries related to liquid detergent enzymes. The novelty of the present study is that it was conducted in a detergent plant producing liquid detergents using only liquid enzymes. The plant never produced powdered detergent products and neither used powdered nor encapsulated enzymes. This study was conducted among all workers in the plant who were potentially exposed to liquid detergent enzymes. The first aim of this study ...

The Health Council of the Netherlands published a report in which the best procedure and method for recommending health-based occupational exposure limits (OELs) for inhaled allergens were identified by evaluating the scientific state of the art. Many respiratory disorders in the workplace arise from inhalation of substances which can cause allergy. To protect workers against respiratory allergy, various preventive measures are taken, one of them being reduction of exposure by setting legally binding standards. These are based on health-based OELs that specify a level of exposure to an airborne substance, a threshold level, below which it may reasonably be expected that there is no risk of adverse health effects. The Council is of the opinion that an OEL should prevent against allergic sensitization, as sensitization plays a crucial biological role and is a prerequisite for the development of allergy. Furthermore, the Council considers it most likely that the exposure level below which no allergic sensitization develops for most allergens is so low, that OELs are difficult to set with the current knowledge and technical feasibilities. An alternative approach is to accept exposure, which carries a small predefined risk in developing allergic sensitization. In addition, it is worth considering periodic screening of exposed workers on allergic sensitization, because timely intervention can prevent worse. The feasibility of periodic screening and what else is needed to comply with the most important criteria, should however be judged case-by-case.