Occupational rhinitis and asthma due to EDTA‐containing detergents or disinfectants

Abstract

This case series is the first report of EDTA-related respiratory disease, documented by a specific test. An irritant mechanism is unlikely. Further studies are required to distinguish between an immunoallergic response and a pharmacological mechanism possibly resulting from calcium chelation, as suggested by animal experiments. A ban of spray preparations would be sufficient to prevent respiratory disease induced by EDTA inhalation, regardless of its mechanism.

Occupational asthma and occupational rhinitis: the united airways disease model revisited

“…The responsibility of repeated exposure to occupational LMW irritants in new-onset asthma, such as acids, bases, oxidants, electrophilic agents, isocyanates or aldehydes, has been suggested by numerous epidemiological studies and case reports 28. Pharmacological mechanisms have been proposed for some LMW agents: release of histamine by persulphate salts,29 quaternary ammoniums,30 or opiates,31 disruption of the cholinergic control of airway responsiveness by organophosphate insecticide,32 calcium chelation by EDTA-containing detergents or disinfectants 33…”

Environment and asthma in adults

“…More objective exposure assessment methods that are applicable to large populations, such as task-exposure matrices or the use of quantitative measurements, need to be developed to improve exposure assessment. Home environments might be major sources of aero-contaminants and it has been suggested that VOC (Volatile Organic Compounds) should be measured at home to better evaluate domestic exposure to cleaning products and potentially to cosmetics, which were recently suggested as a potential risk factor for asthma and allergic diseases [69,[137][138][139]. In recent surveys, home visits using bar codes of various products were performed and may provide objective tools to validate or improve questionnaires used in epidemiological surveys [140,141].…”

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

“…For the present study, all patients investigated by NPT with an aliphatic or alicyclic amine for the diagnosis of OR (alone or associated with asthma) in our occupational health unit between January 2002 and July 2011 were retrieved. Cases challenged with EDTA but no other amine were excluded because they have already been reported in a previous study [Laborde‐Casterot et al, ].…”

“…In our occupational health unit, we use specific nasal provocation tests (NPT) with all potentially sensitising substances present in work exposure products to investigate patients presenting with OR (alone or associated with OA). We have previously published an original series of ethylenediamine tetraacetic acid (EDTA)‐induced OR/OA [Laborde‐Casterot et al, ]. In the present study, we focused on other aliphatic or alicyclic amines challenged with a specific NPT, in a series of OR or OA + OR cases exposed to these agents.…”