Occupational Asthma: New Low-Molecular-Weight Causal Agents, 2000–2010

Abstract

Background. More than 400 agents have been documented as causing occupational asthma (OA). The list of low-molecular-weight (LMW) agents that have been identified as potential causes of OA is constantly expanding, emphasizing the need to continually update our knowledge by reviewing the literature. Objective. The objective of this paper was to identify all new LMW agents causing occupational asthma reported during the period 2000–2010. Methods. A Medline search was performed using the keywords occupational asthma, new allergens, new causes, and low-molecular-weight agents. Results. We found 39 publications describing 41 new LMW causal agents, which belonged to the following categories: drugs (n = 12), wood dust (n = 11), chemicals (n = 8), metals (n = 4), biocides (n = 3), and miscellaneous (n = 3). The diagnosis of OA was confirmed through SIC for 35 of 41 agents, peak expiratory flow monitoring for three (3) agents, and the clinical history alone for three (3) agents. Immunological tests provided evidence supporting an IgE-mediated mechanism for eight (8) (20%) of the newly described agents. Conclusion. This paper highlights the importance of being alert to the occurrence of new LMW sensitizers, which can elicit OA. The immunological mechanism is explained by a type I hypersensitivity reaction in 20% of all newly described LMW agents.

Work related asthma. A causal analysis controlling the healthy worker effect

“…More than 350 agents have already been recognised to cause asthma3 4 and new agents are reported each year 5. Most occupational asthmagens are low or high molecular weight sensitisers, but irritant exposures are receiving increasing attention 6 7…”

A computer based asthma hazard prediction model and new molecular weight agents in occupational asthma: Table 1

“…New agents are frequently reported in the literature, as shown by Pralong et al 8 in their recent review, 41 new LMW agents having been reported between 2000 and 2010.…”

Is the incidence of aliphatic amine‐induced occupational rhinitis and asthma underestimated?

“…Ingredients of cleaning products are mostly low molecular weight molecules for which readily accessible diagnostic methods such as skin tests or laboratory tests are also not available and a specific provocation test is often the only way to confirm the aetiological hypothesis. Comprehensive case investigation is difficult (time‐consuming and sometimes laborious) and is not always performed, which explains why documented cases of cleaning product‐induced OR/OA are scarce: none of the 41 new low‐molecular‐weight causal agents of OA identified in Medline during the period 2000–2010 were reported for cleaning purposes (except for ortho‐phthalaldehyde and a peracetic acid‐hydrogen peroxide mixture employed in the very particular setting of endoscope disinfection) [Pralong et al, ].…”