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A cross-sectional study among detergent workers exposed to liquid detergent enzymes
  1. FGBGJ van Rooy (f.vanrooy{at}uu.nl)
  1. Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Netherlands
    1. R Houba (r.houba{at}nkal.nl)
    1. Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, Netherlands
      1. N Palmen (nicole.palmen{at}encare.nl)
      1. Encare Arbozorg, Maastricht, Netherlands
        1. MM Zengeni (m.zengeni{at}uu.nl)
        1. Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, Netherlands
          1. I Sander (sander{at}bgfa.ruhr-uni-bochum.de)
          1. BGFA - Research Institute of Occupational Medicine, German Social Accident Insurance, Germany
            1. J Spithoven (j.j.g.spithoven{at}uu.nl)
            1. Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Netherlands
              1. JM Rooyackers (j.rooijackers{at}nkal.nl)
              1. Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, Netherlands
                1. D J J Heederik (d.heederik{at}uu.nl)
                1. Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Netherlands

                  Abstract

                  Objectives: To investigate sensitisation and respiratory health among workers who produce liquid detergent products and handle liquid detergent enzymes.

                  Methods: We performed a cross-sectional study among 109 eligible workers of a detergent products plant. 108 were interviewed for respiratory and allergic symptoms and from 106 blood samples were taken to examine sensitisation to enzymes. Those, sensitised to one or more enzymes were referred for clinical evaluation. Workers and representatives were interviewed to characterize exposure qualitatively and estimate exposure semi-quantitatively. Workers were classified into three exposure groups with varying exposure profiles to enzymes, based on frequency, duration and level of exposure.

                  Results: Workers were exposed to proteases, α-amylase, lipase and cellulase. The highest exposures occurred in the mixing area. Liquid spills with concentrated enzyme preparations and leakage of enzymes during weighing, transportation and filling were causing workplace contaminations and subsequently leading to both dermal and inhalation exposure for workers.

                  Workers with the highest exposures reported significantly more work-related symptoms of itching nose (prevalence ratio PR=4.2, 95% CI 1.5-12.0) and sneezing (PR=4.0, 95% CI 1.5-10.8) and marginally significant more symptoms of wheezing PR= 2.9 (95% CI 0.9-8.7) compared to the least exposed group.

                  Fifteen workers (14.2 %) were sensitised to one or more enzymes. A marginally statistically significant gradient in sensitisation across the exposure categories was found (p=0.09). A clinical case of occupational asthma was found and two other with probable occupational rhinitis.

                  Conclusions: Workers exposed to liquid detergent enzymes are at risk of developing sensitisation (14 %) and respiratory allergy.

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