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Canadian Respiratory Journal
Volume 19, Issue 3, Pages e25-e27
http://dx.doi.org/10.1155/2012/150919
Case Report

Reactive Airways Dysfunction Syndrome from Acute Inhalation of Dishwasher Detergent Powder

Timo J Hannu,1 Vesa E Riihimäki,2 and Päivi L Piirilä3

1Finnish Institute of Occupational Health, Occupational Medicine, Helsinki, Finland
2Kalenteritie, Espoo, Finland
3Helsinki University Central Hospital, Laboratory of Clinical Physiology, Helsinki, Finland

Copyright © 2012 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Reactive airway dysfunction syndrome, a type of occupational asthma without a latency period, is induced by irritating vapour, fumes or smoke. The present report is the first to describe a case of reactive airway dysfunction syndrome caused by acute exposure to dishwater detergent containing sodium metasilicate and sodium dichloroisocyanurate. The diagnosis was based on exposure data, clinical symptoms and signs, as well as respiratory function tests. A 43-year-old nonatopic male apprentice cook developed respiratory symptoms immediately after exposure to a cloud of detergent powder that was made airborne by vigorous shaking of the package. In spirometry, combined obstructive and restrictive ventilatory impairment developed, and the histamine challenge test revealed bronchial hyper-responsiveness. Even routine handling of a strongly caustic detergent, such as filling a dishwasher container, is not entirely risk free and should be performed with caution.