Enzymes and Work-Related Asthma

Details

• Corporate Authors:
  Michigan State University. College of Human Medicine
• Description:
  Enzymes derived from bacteria, fungi or livestock are widely used in commercial products and laboratories. Awareness of their allergenic potential from airborne exposure was recognized in the 1960's when enzymes were first used as additives in cleaning detergents. Table I lists the enzymes associated with work-related asthma, the source of those enzymes and the industries where the enzymes are used. All the enzymes in Table I have been shown by specific antigen challenge testing to cause asthma. Sensitized individuals have been shown to have both positive skin tests and IgE-specific antibodies to the individual enzymes. The references list the key articles for the medical testing. The allergic potential of enzymes is not just of importance in the workplace. The etiologic antigens of many common environmental allergens are enzymes. For example, house dust mite antigens include amylase, protease, and trypsin; and cockroach antigen includes a protease. Determining enzyme-related asthma is no simple task. Specific antigen bronchoprovocation challenge testing is not part of standard medical care. In addition, amylase is the only enzyme for which standard clinical laboratories can measure IgE-specific antibodies. Measurement with skin testing of IgE-specific antibodies to other enzymes or antigens have been developed by individual researchers, but such testing is not available in the normal clinical setting. Further, there are often multiple other non-enzyme-related exposures in the workplace that can cause asthma. Examples of such workplaces include a detergent manufacturer, a bakery, a grain mill, a grain storage facility and a health care setting. Therefore, it is not surprising that it is often difficult to isolate the specific allergen from the clinical history for an individual who develops work-related asthma in these types of industries. However, the identification of a specific enzyme through a clinical history may be feasible for patients who work in some health care or production settings. For example, if a nurse or pharmacist has an immediate reaction after handling or mixing a pancreatic extract, the clinical history would point to that enzyme as the putative agent associated with the patient's asthma. In a factory setting, a worker with an immediate reaction during the mixing of an enzyme as an additive to a product would point to that enzyme as the agent associated with the patient's asthma. Additionally, peak flow testing or repeated spirometry measurements performed at work and away from work may confirm the work relatedness of symptoms in an industry where enzyme use is the likely asthma-causing agent. [Description provided by NIOSH]
• Subjects:
  Asthma, Occupational Diagnosis Enzymes Epidemiology Hypersensitivity Lung Diseases Occupational Exposure Occupational Health Respiratory Tract Diseases Safety
• Keywords:
  Allergens Clinical Diagnosis Lung Disease Occupational Asthma Occupational Exposure
• Publisher:
  Michigan State University-College of Human Medicine
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Newsletter
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-4
• Volume:
  24
• Issue:
  4
• NIOSHTIC Number:
  nn:20054607
• Citation:
  Project S.E.N.S.O.R. News 2013 Aug; 24(4):1-4
• Contact Point Address:
  MSU-CHM, 117 West Fee Hall, East Lansing, MI 48824-1316
• Federal Fiscal Year:
  2013
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Project S.E.N.S.O.R. News
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8690f57bb3b245a3e4a529d8947df451f087cf7dbfbad09decb96fafc3a0dab77040d7d4f7eab50180e80c13f1fdbb7e227582219a8cdbb6e71d430215497ffa
• Download URL:
  https://stacks.cdc.gov/view/cdc/217105/cdc_217105_DS1.pdf
• File Type:
  [PDF - 97.82 KB ]