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

Table 1

New agents causing OA.

Substances	Ref-; erence	Workplace	No. of cases	Symptoms	Immunological tests		Functional tests			SIC	Remark
					SPT	IgE	Increased NSBR	PEF
Drugs
Vancomycin	[17]	Pharmaceutical company	1	A, R	−	−	+	+	ND	NA	Intradermal test +/Histamine release test +
Colistin	[18]	Pharmaceutical company	1	A, R	ND	−	−	ND	+	EAR	NSBR negative before SIC
7-ACSA	[19]	Pharmaceutical company	2	A (2/2), R (1/2)	+ (1/2)	+ (1/2)	+ (2/2)	ND	+ (2/2)	EAR (1/2) NS (1/2)
Thiamphenicol	[20]	Pharmaceutical company	3	A (3/3), R (3/3)	+ (2/3)	+ (2/3)	+ (3/3)	ND	+ (3/3)	EAR (2/3) LAR(1/3)
Cefteram	[21]	Pharmaceutical company	2	A	+ (2/2)	+ (2/2)	+ (2/2)	ND	+ (2/2)	EAR (2/2)
7-TACA	[22]	Pharmaceutical company	1	A, R	ND	ND	−	ND	+	EAR	Increased nasal eosino count after SIC/NSBR negative before and after SIC
Thiamine	[23]	Cereal manufacture	2	A (2/2)	ND	− (1/1)	+ (1/1)	+ (2/2)	+ (2/2)	LAR (2/2)	Hypoxemia after SIC: pO2 45 mm Hg
Lasamide and precursors	[24]	Pharmaceutical company	3	A (3/3), R (3/3)	ND	ND	+ (2/3)	ND	+ (3/3)	EAR (3/3)	NSBR negative before SIC in 1 subject
Aescin	[25]	Pharmaceutical company	1	A, R	ND	ND	+	+	+	AAR
Sevoflurane and isoflurane	[26]	Hospital, anaesthetic staff	2	A (2/2), R (1/2), AR (1/2)	ND	ND	+ (2/2)	+ (1/2)	+ (1/2)	LAR
Mitoxantrone	[27]	Hospital, oncology staff	1	A, R	ND	ND	+	ND	+	LAR	BAL: increase in neutrophils, lymphocytes and eosino after SIC
5-ASA	[28]	Pharmaceutical company	1	A	−	ND	+	ND	+	LAR	Increase in sputum eosino after SIC/Increase in eNO level after SIC
Total: 12			20	A 20/R 13/D 0	5/9	5/10	16/19	5/6	18/19	EAR 10/LAR 6/AAR 1/NS 1
Wood dust
Tali	[29]	Carpentry	2	A (2/2), R (2/2)	− (0/2)	− (0/2)	+ (2/2)	+ (2/2)	+ (2/2)	LAR (1/2) DAR (1/2)	Increase in sputum eosino after SIC (2/2)
Jatoba	[29]	Carpentry	1	A, R	−	−	+	+	+	EAR	Increase in sputum eosino after SIC
Chengal	[30]	Carpentry	1	A, R	ND	ND	ND	+	+	EAR
Falcata	[31]	Wood furniture plant	1	A	ND	ND	ND	ND	+	EAR	Intradermal test +/Specific IgG +
Cedroarana	[32]	Carpentry	1	A, R	+	+	−	ND	+	EAR	Nasal provocation test +/NSBR negative before and after SIC
Bethabara	[33]	Railway platform	1	A	ND	ND	+	ND	+	LAR	Increase in sputum eosino after SIC
Angelim pedra	[34]	Carpentry	1	A, R	+	+	+	ND	+	EAR
Ipe	[35]	Wood work	1	A	+	−	ND	ND	+	LAR
Antiaris	[36]	Door manufacture	1	A, R	+	+	+	ND	+	DAR	Conjunctival provocation test +
African cherry	[37]	Carpentry	1	A	−	ND	+	ND	+	DAR
Sapele	[38]	Carpentry	1	A, R, D	−	+	ND	ND	ND	NA
Total: 11			12	A 12/R 8/D1	4/9	4/8	7/8	4/4	11/11	EAR 5/LAR 3/DAR 3
Metals
Manganese	[39]	Welding	1	A	−	ND	+	+	+	EAR	Increase in sputum eosino and basophils after SIC
Rhodium	[40]	Electroplating plant	1	A, R	+	−	+	ND	+	EAR
Stellite	[41]	Machine manufacture	1	A	−	ND	+	+	+	DAR
Iron (fumes)	[42]	Welding	3	A (3/3)	ND	ND	+ (3/3)	+ (1/3)	+ (3/3)	DAR (1/3) AAR (2/3)	Increase in sputum neutrophils after SIC (3/3)
Total: 4			6	A 6/R 1/D 0	1/3	0/1	6/6	3/5	6/6	EAR 2/DAR 2/AAR 2
Chemicals
Uronium salts	[43]	Peptides synthesis lab	1	A, R	+	−	+	ND	+	EAR	Increase in sputum eosino after SIC
Dodecanedioic acid gel flux	[44]	Electronics company	1	A, R	ND	ND	+	+	+	EAR	Low eNO level before SIC
Adipic acid flux	[45]	Soldering	1	A	ND	ND	+	+	+	LAR
3-amino-5-mercapto-1,2,4-triazole	[46]	Production of herbicides	6	A (6/6), R (6/6)	ND	ND	+ (6/6)	+ (3/4)	ND	NA
Sodium disulphite	[47]	Lobster fishing	1	A	−	−	+	+	+	EAR
Tetramethrin	[48]	Insect extermination firm	1	A	−	ND	+	ND	+	DAR
Eugenol	[49]	Hairdressing salon	1	A, R, D	−	ND	+	ND	+	LAR	Increase in sputum eosino and lymphocytes after SIC
Artificial flavour	[50]	Popcorn popping company	3	A	ND	ND	ND	ND	ND	NA
Total: 8			15	A 15/R 9/D1	1/4	0/2	12/12	6/7	6/6	EAR 3/LAR 2/DAR 1
Biocides
Nitrogen trichloride	[51]	Swimming-pool	3	A	ND	ND	+ (1/3)	+ (2/3)	+ (3/3)	EAR (2/3) DAR (1/3)	NSBR negative before SIC in 1 subject and negative before and after SIC in another subject
PA-HP	[52]	Endoscopic unit	2	A (2/2), R (2/2)	ND	ND	+ (2/2)	+ (1/1)	+ (1/1)	LAR	Increase in sputum eosino after SIC (1/1)
Ortho-phthalaldehyde	[53]	Endoscopic unit	1	A, D	ND	ND	ND	ND	ND	NA
Total: 3			6	A 6/R 2/D1	ND	ND	3/5	3/4	4/4	EAR 2/LAR 1/DAR 1
Miscellaneous
Fluazinam	[54]	Fungicides manufacture	1	A	ND	ND	+	+	+	LAR
Chlorothalonil	[54]	Fungicides manufacture	1	A	ND	ND	−	+	+	LAR	NSBR negative before SIC and borderline after SIC
Chlorendic anhydride	[55]	Mechanic work	1	A, D	+	+	ND	+	ND	NA
Total: 3			3	A 3/R 0/D1	1/1	1/1	1/2	3/3	2/2	LAR 2
Total: 41			62	A 62/R 33/D 4	12/26	10/22	45/52	24/29	47/48	EAR 22/LAR 14/DAR 7/AAR 3/NS 1/47

Legend: A: asthma, R: rhinitis, D: dermatitis; U: urticaria; AR: anaphylactic reaction; PEF: peak expiratory flow, SIC: specific inhalation challenge SPT: skin prick test, IgE: specific immunoglobulin E, NSBR: nonspecific bronchial responsiveness EARs: early asthmatic reaction, LAR: late asthmatic reaction, DAR: dual asthmatic reaction, AAR: atypical asthmatic reaction ND: not done, NA: not available, NS: not specified, eosino: eosinophils, 7-ACSA: 7-aminocephalosporanic acid, 7-TACA: 7-amino-3-thiomethyl-3-cephalosporanic acid, 5-ASA: 5-aminosalicylic acid, PA-PH: peracetic acid-hydrogen peroxyde mixture, BAL: bronchoalveolar lavage, eNO: exhaled nitric oxyde, IgG: immunoglobulin G.