Relevance of sensitization to occupational allergy and asthma in the detergent industry

Abstract

There exists considerable historic experience of the relationship between exposure and both the induction of sensitization and the elicitation of respiratory symptoms from industrial enzymes of bacterial and fungal origin used in a wide variety of detergent products. The detergent industry in particular has substantial experience of how the control of exposure leads to limitation of sensitization with low risk of symptoms. However, the experience also shows that there are substantial gaps in knowledge, even when the potential occupational allergy problem is firmly under control, and also that the relationship between exposure and sensitization can be hard to establish. The latter aspect includes a poor appreciation of how peak exposures and low levels of exposure over time contribute to sensitization. Furthermore, while a minority of workers develop specific IgE, essentially none appear to have symptoms, a situation which appears to contradict the allergy dogma that, once sensitized, an individual will react to much lower levels of exposure. For enzymes, the expression of symptoms occurs at similar or higher levels than those that cause induction. In spite of some knowledge gaps, medical surveillance programs and constant air monitoring provide the tools for successful management of enzymes in the occupational setting. Ultimately, the knowledge gained from the occupational setting facilitates the completion of safety assessments for consumer exposure to detergent enzymes. Such assessments have been proven to be correct by the decades of safe use both occupationally and in consumer products.

Thresholds in chemical respiratory sensitisation

“…Thus, OELs for enzymes in detergent manufacturing are typically in the range of 5-15 ng/m 3 . Through use of these limits sensitisation has been minimised and symptoms avoided in workforces handling a range of enzymes (Basketter et al, 2010(Basketter et al, , 2012Peters et al, 2001;Sarlo, 2003). It can be concluded, therefore, that in the case of human respiratory sensitisation to proteins there is evidence for thresholds even if they may not currently be specified numerically.…”

Enzymes in cleaning products: An overview of toxicological properties and risk assessment/management

“…The extensive evidence that this approach has been successful in the prevention of occupational disease has been reported in detail elsewhere (e.g. Schweigert et al, 2000;Basketter et al, 2012b).…”

“…Normally this is achieved by targeted annual health surveillance, including detection of the presence of enzyme protein specific IgE (Bernstein, 2007). In this sense, the presence of positive IgE does not represent an adverse health effect, decades of experience having shown that these individuals do not progress to experience allergic symptoms unless there is significant exposure above the defined safe levels (Basketter et al, 2012b). What the detection of the presence of IgE does do is to provide a highly practical and relevant measurable point of control.…”

“…In the light of the positive results seen in animal tests (Sarlo et al, 1997;Robinson et al, 1998) and the compelling human experience (reviewed in Basketter et al, 2012b), the most appropriate action must be to consider that all types of industrial enzymes have the potential to act as respiratory sensitisers, unless this can be proven otherwise. Risk assessment and risk management can then proceed on this basis (Basketter et al, 2010).…”

The Danish National Database for Asthma: establishing clinical quality indicators

“…In patients suspected of occupational allergy, clarification is of major importance to identify symptom-triggering allergens, affecting the patients’ future employment (110). …”