Asthma and pulmonary disorders in cheese makers


Occupations
  • Cheese finer
  • Cheese maker
  • Cheese washer
Agents
Acarus siro, Chymosin, House dust mite, Lysozyme, Mite, Penicillium casei, Pepsin, Tyrophagus casei.
 
Incidence
Incidence: 10% of the work force may be affected.
 
Most of the asthmatic subjects are also atopic.
 
Various immunological reactions can be involved depending upon whether the subject is suffering from asthma or alveolitis.
 
Conditions
Cheeses may be contaminated by mites in addition to the moulds normally present and by the addition of enzymes in semi-industrial preparations (egg lysozyme).
 
Symptoms
Classic asthma and/or pseudo flu symptoms with cough, dyspenoea and fever. In the case of asthma, rhinitis symptoms may also be present. Whilst there is an IgE-dependant mechanism, the most common symptoms are: rhinitis, rhino-conjunctivitis, dysphonia and even oedema of the glottis.
 
Diagnostic methods
Skin prick test and/or IDR with house dust mites and moulds.
 
Immunological dosage: RAST/CAP RAST and precipitins.
 
Bronchial provocation test (in hospital) in the case of asthma.

References

  1. Allergy 1996,51:959 - Marcer G. et al.
  2. Chest 1983,83:584
  3. Schweiz. Med. Wochenschr. 1969,99:872
  4. Rev. Fr. Mal. Resp. 1979,7:41
  5. Rev. Fr. Allergol. 1977,17:235

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