Asthma caused by coloring reagents


Occupations
  • Chemical laboratory staff
  • Dry cleaner
  • Dyeing industry
  • Photographic processing
  • Tanner
  • Textile industry
Agents
Acryolamine, Hetrocyclic nitrogen and halogen compounds, Pyrazolon, Vinylsulfone.
 
Incidence
Incidence: 5 to 15% of exposed subjects.
 
Asthma occurs 2 to 6 years after contact. Sensitization occurs during the mixing of the powders. The hapten is fixed either by substitution (heterocyclic halides and vinylsulphones) or by addition (acrylamine).
 
IgE-dependent mechanism. There is a heterogenicity of epitopes with regard to the RD-HSA, complex.
 
Conditions
Colouring agents associated with chromophores act as electrophilic haptens. They are attached to the fibres by strong covalent bonds. The reactive groups which have the highest association with allergic reactions are: bromoacrylamide, dichlorotriazin, monochlorotriazin, monochlorodifluoropyrimidin, vinyl sulfone, fluorotriazine and pyrazolon. In the case of personnel working in the photographic industry, it is a suspension of a powder containing pyrazolon which, following several minutes exposure, gives rise to clinical signs of bronchoconstriction.
 
Symptoms
A spasmodic cough (due to chlorine and sulphuric acid anhydride fumes) is often present. Asthma is preceded by rhinitis and is linked with work initially, but becomes permanent. Urticaria and eczema may develop at the same time.
 
Diagnostic methods
Skin prick test with extracts of the combined colouring agents. Skin tests using 10 mg/ml of colouring agent with vinyl sulfone in 0.4 % phenol and 0.9 % saline have been proposed.
 
Measurement of specific IgE titre by RAST or by ELISA technique, with the conjugated HSA allergens. These 2 tests are complementary.
Bronchial provocation test (in hospital).

References

  1. Occup. Environ. Med. 2001,58:411 - Park JW. et al.
  2. Clin. Exp. Allergy 2001,31:1779 - Park JW. et al.
  3. Chest 2000,118:246 Nakano Y. et al.
  4. Rev. Mal. Respir. 1999,16:384 - Spirlet F. et al.
  5. Occup. Med. 1997,47:491 - Palmer K. et al.
  6. Eur. Respir. J. 1997,10:238 - Convery RP. et al.
  7. Fiche All. Prof. INRS
  8. Contact Dermatitis 1988,18:290
  9. Contact Dermatitis 1986,15:186
  10. Clin. Allergy 1978,8:25
  11. Br. J. Ind. Med. 1987,44:534
  12. Br. J. Ind. Med. 1977,44:534

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.