Asthma caused by sulfones chloramides


Occupations
  • Cellarman
  • Chemical industry
  • Dyeing industry
  • Food industry
  • Hairdresser
  • Laundry worker
  • Paper industry
  • Pharmaceutical industry
  • Tanner
Agents
Bisulphites, Persulphates, Potassium metabisulphites, Sodium metabisulphites, Sulphites.
 
Incidence
Incidence: increasing - probably due to the proportion of atopic subjects working in these areas. 50% of affected subjects are atopic. IgE-dependent mechanism although there may also be an interference with arachidonic acid metabolism. The limits recommended for occupational exposure to sulphite and metabisulphite is 5 mg/m3. There are also limits set for the food industry. The gravity of the problem lies in the constant risk of triggering an asthmatic attack through the inadvertent consumption of the allergen. In a factory producing persulphates, it was demonstrated that the drop in bronchial flow was greater in those subjects who has a positive skin prick test.
 
Conditions
The role of sulphites as occupational inhaled allergens is less well known and its description more recent than that of preservatives in food allergy. In contrast, persulphates are widely used as bleaching agents.
 
Symptoms
Asthma and rhinitis are frequently associated with urticaria, eczema, flush and hypotension. Ingestion of sulphites may cause anaphylactic shock in sensitized subjects.
 
Diagnostic methods
Skin tests are possible, but extracts are not commercially available.
 
Bronchial provocation test (in hospital).
 
Monitoring respiratory parameters in the work place. Patch tests with ammonium persulphate are frequently positive in the case of eczema, but persulphates also often give positive skin- prick tests.

References

  1. Allergy 1999,54:893 - Borelly S. et al.
  2. Int. Arch. Occup. Environ Health 1995,67:413
  3. Thorax 1989,44:12
  4. Respiration 1979,38:144
  5. Rev. fr. Allergol.1966,8:150
  6. Clin. Allergy 1976,6:399
  7. Ann. Allergy 1985,54:213
  8. J. Allergy Clin. Immunol.1986,78:191
  9. J. Allergy Clin. Immunol.1984,74:469
  10. J. Allergy Clin. Immunol.1984,74:511

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