Short report
Occupational asthma caused by bacillary amylase used in the
detergent industry
A M Hole, A Draper, G Jolliffe, P Cullinan, M Jones, A J Newman Taylor
Department of
Occupational and Environmental Medicine, Royal Brompton Hospital and
Imperial College School of Medicine, London, UK
Correspondence to: Mrs A M Hole, Department of Occupational and Environmental Medicine, Imperial College (NHLI), 1b Manresa Road, London SW3 6LR, UK A.M.Hole{at}rbh.nthames.nhs.uk
Accepted 31 August 2000
Four cases are reported of occupational asthma due to amylase
derived from Bacillus licheniformis, used in
detergent washing powders. It is thought that these are the first
reported cases of asthma due to this enzyme in the detergent industry.
All four employees (men) were from the same factory and none had a
history of asthma or atopy. All developed symptoms of wheeze at work
after an initial symptom free period. Symptoms improved during periods away from work. All undertook serial peak flow recordings (not diagnostic) and underwent skin prick tests, radio allergosorbent test
(RAST) measurement, and specific bronchial provocation testing. The
bronchial provocation testing was performed by a dust tipping method in
a single blind manner, with lactose as an inert control and powdered
amylase, provided by the employer, as an active agent. Serial
measurements of forced expiratory volume in 1 second (FEV1) were recorded and histamine provocative concentration causing a 20%
fall in FEV1 (PC20) tests were determined
before and 24 hours after each challenge. Patient 1 developed an
isolated early reaction, patient 2 an isolated late reaction, and
patients 3 and 4 developed dual reactions. All showed an increased
non-specific bronchial responsiveness after active challenge. The
introduction of encapsulated enzymes in the detergent industry was
followed by a reduction in the incidence of respiratory sensitisation. These patients developed occupational asthma despite working only with
encapsulated enzymes. This highlights the importance of careful surveillance after the introduction of new agents in the workplace.
Keywords: occupational asthma; detergent enzyme; amylase
© 2000 by Occupational and Environmental Medicine
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