Subject(s)
Dermatitis/immunology , Hypersensitivity/immunology , Nickel/immunology , CD4-Positive T-Lymphocytes/immunology , CD4-Positive T-Lymphocytes/metabolism , CD8-Positive T-Lymphocytes/immunology , CD8-Positive T-Lymphocytes/metabolism , Cytokines/metabolism , Dermatitis/pathology , Dermatitis, Allergic Contact/immunology , Dermatitis, Allergic Contact/pathology , Humans , Hypersensitivity/pathology , Hypersensitivity, Delayed/etiology , Hypersensitivity, Delayed/immunology , Hypersensitivity, Delayed/pathology , Hypersensitivity, Immediate/etiology , Hypersensitivity, Immediate/immunology , Hypersensitivity, Immediate/pathologyABSTRACT
Occupational asthma is defined as variable airflow obstruction and airways hyperresponsiveness caused by exposure to agents present in the workplace. Low molecular weight agents such as isocyanates, aldehydes, anhydrides, colophony, dyes, persulphate, amines, acrylates and metals are steadily increasing as causative agents of occupational asthma. Isocyanates, aldehydes and anhydrides my cause sensitisation through an IgE mediated response in some workers. These agents act as haptens which combine with a carrier protein to form a complete antigen. Assays for the detection of specific IgE are standardized for very few agents and have a good specificity, but poor sensitivity. The diagnosis of occupational asthma relies not only on a suggestive hystory showing that asthma is caused or exacerbated specifically by work exposure, but in most cases needs to be confirmed by objective means. Combined monitoring of lung function parameters, such as peak expiratory flow rate at the work site and non specific bronchial hyperresponsiveness during and away from exposure, is necessary. The "gold standard" for confirming a diagnosis in an individual worker still remains the specific bronchoprovocation test, which has now reached a high degree of sensitivity, specificity and reproducibility for agents such a s isocyanates. In occupation asthma due to low molecular weight agents there are no individual risk factors which could predict the susceptibility to develop the disease. The primary prevention is based on appropriate interventions tn the workplace. The strict medical surveillance of workers may allow the early diagnosis and removal from further exposure in order to prevent morbidity and disability.
Subject(s)
Asthma/chemically induced , Occupational Diseases/chemically induced , Adult , Air Pollutants, Occupational/adverse effects , Asthma/diagnosis , Asthma/epidemiology , Female , Humans , Italy/epidemiology , Male , Metals/adverse effects , Middle Aged , Molecular Weight , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Organic Chemicals/adverse effects , Prevalence , United Kingdom/epidemiology , United States/epidemiologyABSTRACT
Here, we report our experience on benzoate hypersensitivity. Drug and food additives are known to induce pseudo-allergic reactions such as urticaria, eczema, asthma and rhinitis. These reactions are often under-diagnosed, above all in allergic patients treated with additive containing drugs. On the contrary, attention to the additives present in some drug formulations and foods may often permit more correct diagnosis.
