Occupational asthma and allergy in the detergent industry: new developments

Abstract

This review highlights the latest developments in the control of enzyme-induced occupational asthma and allergy (rhinitis and conjunctivitis) in the detergent industry. The industry has developed guidelines for the safe handling of enzymes in order to reduce the risk of occupational allergy and asthma. Those manufacturing facilities that follow all of the guidelines enjoy very low or no cases of asthma and allergy among workers exposed to enzymes. The key to the success of the management of enzyme-induced allergy and asthma is prospective surveillance for the development of enzyme-specific IgE antibody before the onset of allergic symptoms. This allows for continuing interventions to reduce exposures, so as to minimize or eliminate those associated with symptoms. Workers with IgE to enzymes can still continue to work in the industry symptom-free for their entire career. This indicates that exposures needed to induce sensitization are different and probably lower than exposures needed to elicit enzyme allergic symptoms. The experience of the detergent enzyme industry in controlling occupational allergens can be applied to other industries. The detergent enzyme story can be viewed as a model for the control of type 1 protein allergens in the workplace.

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

“…; 134), wood dust, particularly hard woods (Mahogany, Western Red Cedar, etc. ; 135), mites (136), latex (137), enzymes (138), grains (bakers and agricultural workers; 139,140) and chemicals such as acid anhydrides, platinum salts (141), glues and solvents (142). Occupational rhinitis is frequently underdiagnosed due to under-reporting and/or a lack of doctor awareness (133,143).…”

An ATS/ERS report: 100 key questions and needs in occupational asthma

“…Surveillance programmes have been used in some at-risk industries with different means, at different intervals, and with different approaches [12,44]. With these experiences, how can an ideal surveillance programme be defined?…”

Key issues for the assessment of the allergenic potential of genetically modified foods: breakout group reports.

“…Not all individuals who have IgE against a specific protein will develop clinical symptoms (Sarlo and Kirchner 2002). However, IgE-mediated allergic symptoms and signs will not occur in the absence of sensitization; therefore, sensitization leads to the potential for harm.…”

“…In vivo models could also be used to determine dose-response relationships and whether there are thresholds below which allergenic proteins have no clinical effects. In the detergent industry, exposure levels have been reduced and managed so that between 0 and 3% of the workforce become sensitized in a given year (Sarlo and Kirchner 2002;Schweigert et al 2000). Under these conditions of exposure, clinical disease has been virtually eliminated, indicating that, at least for aeroallergens, there is a threshold for sensitization that may be different than that for elicitation.…”