Objectives-To assess the prevalence of enzyme sensitisation in the detergent industry. Methods-A cross sectional study was conducted in a detergent factory. Sensitisation to enzymes was examined by skin prick and radioallergosorbent (RAST) tests. 76 Workers were tested; 40 in manufacturing, packing, and maintenance, and 36 non-exposed people in management and sales departments. The workers were interviewed for work related respiratory and skin symptoms. Total dust concentrations were measured by a gravimetric method, and the concentration of protease in air by a catalytic method. Results-Nine workers (22%) were sensitised to enzymes in the exposed group of 40, whereas none were sensitised in the non-exposed group. All the sensitised people had symptoms at work; all had rhinitis and one had asthma. Protease concentrations were generally <20 ng/m 3 , but occasional peak values up to 80 ng/m 3 were detected in the packing and maintenance tasks, and high values of >1 µg/m 3 in the mixing area. Conclusion-Despite the use of encapsulated enzyme preparations, high enzyme concentrations in workplace air are possible, resulting in a higher risk of sensitisation than expected. (Occup Environ Med 2000;57:121-125) Keywords: detergent enzymes; occupational exposure; allergyThe detergent industry was the first to give rise to the protease enzyme allergy problem in the late 1960s.1-5 Later, other enzymes, such as -amylases and cellulases emerged as sensitisers-for example, in the baking industry. [6][7][8][9] In the detergent industry, the allergy problem has been considered to be under control since the mid-1970s, due to development of encapsulated protease preparations and improvements in industrial hygiene.4 10 11 It was, however, reported that sensitisation could not be totally prevented by encapsulation of enzymes, 12 and some cases of respiratory allergy have been reported. 13 Recently, new enzymes have been introduced in the detergent industry-such as lipases in the late 1980s, and later cellulases and -amylases-although the proteases derived from Bacillus subtilis are still the most important enzymes. Because of the history of enzyme allergy and the increased range of enzymes in the field, we assessed the prevalence of sensitisation to enzymes and the levels of exposure to protease in a detergent factory. Material and methods DETERGENT FACTORYThe study was carried out in a factory producing laundry detergents and automatic dish washing detergents. The factory had been operating since the 1960s. New facilities were built in the mid-1980s. Detergents for laundry and dish washing were produced in separate departments. The manufacturing of laundry detergents includes mixing of raw materials with water and subsequent spray drying of the slurry, followed by addition of heat labile components such as enzymes. The addition of enzyme to the hopper took place manually a few times in a shift. Further mixing to the detergent was automated. The packing machines were controlled and operated by packers. The factory had mod...

Objectives-To assess the exposure to enzymes and prevalence of enzyme sensitisation in the baking industry. Methods-A cross sectional study was conducted in four bakeries, one flour mill, and one crispbread factory. Sensitisation to enzymes, flours, and storage mites was examined by skin prick and radioallergosorbent (RAST) tests. 365 workers were tested. The workers were interviewed for work related respiratory and skin symptoms. Total dust concentrations were measured by a gravimetric method, and the concentration of a-amylase in air was measured by a catalytic method. An immunochemical method was used for measuring cellulose and xylanase in air. Results-Total measured dust concentrations were from 0-1 to 18 mg/ml, with highest values in dough making areas of bakeries. The a-amylase concentrations generally followed the total dust concentrations and reached the highest values < 66 YugIm' in the same areas. Cellulase and xylanase varied with concentrations < 180 ng/m' and < 40 nglm3, respectively, in the flour mill and the crispbread factory. No cellulase, but concentrations of 1-200 nglm' xylanase, were found in the bakeries, probably indicating the natural xylanase activity of wheat. 12 workers (8%) in the bakeries, three (5%/6) in the flour mill, and four (3%) in the crispbread factory were skin prick positive to enzymes. The corresponding percentages of positive reactions to flours were 12%, 5%, and 8%.Conclusions-The study confirmed that industrial enzymes in baking used as additives in a powdered form pose a risk of sensitisation. The no effect air concentrations for industrial enzymes are not known. Based on present knowledge, however, lowering exposures and eliminating short and high peaks by technical measures would lower the risk of sensitisation. This would be most effectively accomplished by shifting to non-dusty products.

Background: We report on IgE-mediated allergy in a worker caused by Tribolium confusum (confused¯our beetle). These beetles lived in the``old''¯our to which he was exposed in his work. Case report: A 35-year-old, nonatopic mechanic in a rye crispbread factory developed rhinitis, conjunctivitis, and asthmatic symptoms, as well as urticaria on his wrists, lower arms, hands, neck, and face, during the maintenance and repair of machines contaminated by¯our. This¯our had been in and on the machines for a long time, and it contained small beetles. The patient did not suffer any symptoms when handling fresh, clean¯our. Results: Skin prick tests with standard environmental allergens, storage mites, enzymes,¯ours, and molds were negative. A prick test with¯our from the machines gave a 10-mm reaction. An open application of the same¯our caused urticarial whealing on the exposed skin. Prick tests with fresh¯our from the factory were negative. A prick test with minced T. confusum from the¯our in the machines gave a 7-mm reaction. Histamine hydrochloride 10 mg/ml gave a 7-mm reaction. Speci®c serum IgE antibodies to T. confusum were elevated at 17.2 kU/l. Prick tests with the¯our from the machines were negative in ®ve control patients. Conclusions: The patient had occupational contact urticaria, rhinitis, conjunctivitis, and asthmatic symptoms from exposure to¯our. His symptoms were caused by immediate allergy to the beetle T. confusum. Immediate allergy to this beetle has rarely been reported in connection with respiratory symptoms, but it may be more common. Contact urticaria from this source has not been reported before.

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Objectives-To assess the prevalence of enzyme sensitisation in the animal feed industry. Methods-A cross sectional study was conducted in four animal feed factories, where several enzymes had been used in powder form for 7-9 years. Before this study, enzymes in liquid form had started to be used. Sensitisation to enzymes was examined by skin prick and radioallergosorbent (RAST) tests. Altogether 218 workers were tested; 140 people in various tasks in manufacturing, where exposure to various organic dusts and to enzymes was possible, and 78 non-exposed oYce workers. The workers were interviewed for work related respiratory and skin symptoms. Total dust concentrations were measured by a gravimetric method. The concentrations of protease and -amylase were measured with catalytic methods and that of xylanase with an immunological method. Results-Ten workers (7%) were sensitised to enzymes in the exposed group of 140, whereas none were sensitised in the non-exposed group. Six of the sensitised people had respiratory symptoms at work: two of them especially in connection with exposure to enzymes. . On average, highest xylanase and -amylase concentrations were found in the various manufacturing sites, whereas the highest protease concentrations were found in areas of high total dust. Conclusions-Industrial enzymes may cause allergies in the animal feed industry. There is a need to assess exposure to enzymes at various phases of production, and to minimise exposures. (Occup Environ Med 2001;58:119-123)