Epidemic Asthma in Cartagena, Spain, and Its Association with Soybean Sensitivity

Navarro, Carmen; Márquez, M Giovanni; Hernando-Arizaleta, Lauro; Galván, Fernando; Zapatero, L.; Caravaca, Francisco

doi:10.1097/00001648-199301000-00014

Cited by 36 publications

(19 citation statements)

References 15 publications

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“…Epidemic asthma outbreaks have been described in many cities: New Orleans [15], New York [16], Melbourne [17], Birmingham [18], London [19], Barcelona [20], Naples [21], Cartagena (Spain) [22], and Toledo (USA) [23]. Soybean [20][21][22] and castor bean [23] are wellestablished causes of asthma outbreaks.…”

Section: Sporadic and Epidemic Sudden Onset Severe Asthma Exacerbationsmentioning

confidence: 99%

“…Soybean [20][21][22] and castor bean [23] are wellestablished causes of asthma outbreaks. Airborne fungal spores, especially Didymella exitidis and Sporobolomyces [18], and rye grass pollen grains [17] have also been implicated in some urban episodes of epidemic asthma, but definite proof of their implication in asthma outbreaks is still lacking .…”

Section: Sporadic and Epidemic Sudden Onset Severe Asthma Exacerbationsmentioning

confidence: 99%

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Classification of severe asthma exacerbations: a proposal

Picado

1996

Eur Respir J

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C Cl la as ss si if fi ic ca at ti io on n o of f s se ev ve er re e a as st th hm ma a e ex xa ac ce er rb ba at ti io on ns s: : a a p pr ro op po os sa al l C. PicadoClassification of severe asthma exacerbations: a proposal. C. Picado. ERS Journals Ltd 1996. ABSTRACT: The intensity of asthma exacerbations may vary from mild to severe. Many studies have demonstrated that the speed at which severe asthma exacerbation (SAE) develops varies among patients. In some asthmatics, the exacerbation comes on very quickly, whereas in others there is a progressive deterioration of clinical, functional and blood gas parameters.Sudden SAE are characterised by their explosive presentation and quick recovery. This evolution contrasts with that of patients with a slow onset SAE, who often need prolonged hospitalization. Absence of secretions suctioned from the airways during mechanical ventilation has been reported in sudden SAE, whereas large amounts of viscid mucus are found in patients with the slow onset SAE. The lungs of patients who died during a sudden onset SAE often show empty airways and a predominant neutrophilic infiltration in the bronchial epithelium, in contrast to the presence of abundant eosinophils in patients who died during a slow onset SAE.Sudden onset SAE may occur as sporadic cases or in outbreaks. Sporadic cases may result from the ingestion of nonsteroidal anti-inflammatory drugs (NSAID) in patients with intolerance to these products, massive exposure to common allergens and ingestion of foods containing sulphites. Asthma outbreaks have been described in many cities. In contrast to sudden onset SAE, slow onset SAE is characterized by a progressive deterioration, accompanied by an increase in the use of bronchodilators. Lack of appropriate monitoring of function by peak expiratory flow (PEF) recording, failure of patients to recognize worsening symptoms and underusage of inhaled and oral steroid treatment have been repeatedly identified as factors which are likely to be associated with slow onset SAE. The contribution of psychosocial problems, depression, denial of asthma severity and nonadherence with the treatment should not be overlooked in patients with slow onset SAE.Classification of severe asthma exacerbations into two types (sudden onset and slow onset) could help to reveal the aetiology of the attack and may also be relevant to the management of the patient.

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Section: Sporadic and Epidemic Sudden Onset Severe Asthma Exacerbationsmentioning

confidence: 99%

Section: Sporadic and Epidemic Sudden Onset Severe Asthma Exacerbationsmentioning

confidence: 99%

Classification of severe asthma exacerbations: a proposal

Picado

1996

Eur Respir J

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“…In Spain, during the unloading of soybeans in the harbour, soybean dust became airborne causing epidemics of asthma (Anto and Sunyer, 1986;Anto et al, 1989;Hernando et al, 1989;Gonzalez et al, 1992;Anto et al, 1993;Navarro et al, 1993). The soybeans were unloaded by a vacuum system, but the silos did not have dust filters installed in the collection system, so that large quantities of soybean dust were released into the air (Anto et al, 1989).…”

Section: Aeroallergens From Seedsmentioning

confidence: 99%

Aeroallergens of plant origin: Molecular basis and aerobiological significance

1995

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This review presents an update on the sources and molecular basis of aeroallergens of plants, derived from pollen, seeds, leaf and stem detritus and their protein molecules. These aeroallergens are a natural component of the atmosphere, either because of their natural function or human activity. Pollen is a source of allergens within the 10-200 #m size range, and while most allergenic pollen types account for only 20-30~ of total annual pollen catch, during their flowering season, they are usually the dominant type. Tree pollen commences the season in winter, with birch pollen counts in Scandinavia being the highest daily pollen counts yet reported and a major allergen, a 14-kDa protein, which is similar to pathogenesis-related proteins. Grass pollen follows in spring, and is unique as its two immunodominant allergens, a 35-kDa glycoprotein and 28-32-kDa protein, are in different cellular sites: the cytosol and surface of pollen grains; and in intracellular starch granules. The allergens at the pollen surface are not inhalable and can interact only with the eyes, nasal and oral cavities. Starch granules are released to the atmospheric aerosol when grains rupture in rainwater. These are a major source of allergen-containing micronic particles, which are important because they are inhalable. At the same time, allergen molecules are present in the aerosol, and these can bind to soot particles, and so be respired deep into the airways. The major Japanese cedar pollen allergen has been detected both within the pollen and in orbicules; particles less than 1 tLm that line the anther cavity and can be released into the air when dehiscence occurs. Ragweed is the major cause of late summer hayfever in eastern North America, where its pollen accounts for up to 41% of the annual pollen catch. It is a major source of aeroallergens in both respirable and non-respirable size ranges. As a result of human activity, dusts derived from seeds and cereal grains during transport, storage and milling provide a source of micronic particles, containing potent allergens that can trigger allergic disease.

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“…Exposure to inhaled soya allergens has been linked with occupational asthma [4,5], rhinitis [6], hypersensitivity pneumonitis [7], and epidemics of asthma [8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Quantifying Dustiness, Specific Allergens, and Endotoxin in Bulk Soya Imports

et al. 2017

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Soya is an important bulk agricultural product often transported by sea as chipped beans and/or the bean husks after pelletisation. There are proven allergens in both forms. Bulk handling of soya imports can generate air pollution containing dust, allergens, and pyrogens, posing health risks to dockside workers and surrounding populations. Using an International Organization for Standardization (ISO) standardised rotating drum dustiness test in seven imported soya bulks, we compared the generated levels of dust and two major soya allergens in three particle sizes related to respiratory health. Extractable levels of allergen and endotoxin from the bulks showed 30-60 fold differences, with levels of one allergen (hydrophobic seed protein) and endotoxin higher in husk. The generated levels of dust and allergens in the three particle sizes also showed very wide variations between bulks, with aerolysed levels of allergen influenced by both the inherent dustiness and the extractable allergen in each bulk. Percentage allergen aerolysed from pelletized husk-often assumed to be of low dustiness-after transportation was not lower than that from chipped beans. Thus, not all soya bulks pose the same inhalation health risk and reinforces the importance of controlling dust generation from handling all soya bulk to as low as reasonably practicable.

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Epidemic Asthma in Cartagena, Spain, and Its Association with Soybean Sensitivity

Cited by 36 publications

References 15 publications

Classification of severe asthma exacerbations: a proposal

Classification of severe asthma exacerbations: a proposal

Aeroallergens of plant origin: Molecular basis and aerobiological significance

Quantifying Dustiness, Specific Allergens, and Endotoxin in Bulk Soya Imports

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