Asthma caused by combustion products of polyvinyl chloride


Occupations
  • Fireman
  • Food packaging industry,
  • Plastic bottle/bottling industry
Agents
Diocetyl phtalate, Phthalic anhydride, PVC.
 
Incidence
Incidence: much greater amongst smokers. IgE-dependent mechanism.
 
In firemen exposed to large quantities of PVC combustion products, RADS (Reactive airways dysfunction syndrome or asthma caused by irritants – Brooks syndrome) may occur. The long term effects may involve chronic bronchitis. Smoking is clearly an aggravating factor.
 
Conditions
Heat-sealing of plastic packaging materials (e.g. in food packaging).
 
The pathology is also known under the name of meat packer's illness.
 
Production line work in the manufacture of plastic bottles.
 
Symptoms
Cough, expectoration and asthma symptoms initially associated with work then becoming persistent elsewhere. Rhinitis and irritative conjunctivitis with headache. Possibility of acute asthma.
 
Diagnostic methods
Skin prick test or IDR with PA-HSA; scratch test 6.8x10-3 mol/l.
 
Immunological assay: PTRIA with PA-HSA or PA-BSA, RAST/CAP RAST with phthalic anhydride.
 
Bronchial provocation test (in hospital).

References

  1. INRS 2000 DMT 82 TR 25 page 153 Rosenberg N
  2. Med. Lav. 1999,90:513 - Cipolla C. et al.
  3. Arch. Environ. Health 1989,44:30
  4. A. J. Ind. Med. 1988,14:273
  5. Am. Rev. Resp. Dis. 1976,113:701
  6. J. Allergy Clin. Immunol.1982,69:311

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