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A cross-sectional study among detergent workers exposed to liquid detergent enzymes
  1. F G B G J van Rooy1,2,3,
  2. R Houba1,
  3. N Palmen4,
  4. M M Zengeni1,2,
  5. I Sander5,
  6. J Spithoven2,
  7. J M Rooyackers1,6,
  8. D J J Heederik2,7
  1. 1
    Netherlands Expertise Centre for Occupational Respiratory Disorders, Utrecht, The Netherlands
  2. 2
    Division Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands
  3. 3
    Arbo Unie Expert Centre for Chemical Risk Management, Utrecht, The Netherlands
  4. 4
    Encare Arbozorg, Maastricht, The Netherlands
  5. 5
    BGFA - Research Institute of Occupational Medicine, Institute of the Ruhr University of Bochum, Bochum, Germany
  6. 6
    Division Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands
  7. 7
    Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
  1. Correspondence to Frits van Rooy, Division Environmental Epidemiology, Institute for Risk Assessment Sciences, P.O. Box 80.178, NL-3508 TD Utrecht, The Netherlands; f.vanrooy{at}


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 106 blood samples were taken from them to examine sensitisation to enzymes. Those sensitised to ⩾1 enzymes were referred for clinical evaluation. Workers and representatives were interviewed to characterise 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 to 12.0) and sneezing (PR = 4.0, 95% CI 1.5 to 10.8) and marginally significant more symptoms of wheezing (PR = 2.9, 95% CI 0.9 to 8.7) compared with the least exposed group.

Fifteen workers (14.2%) were sensitised to ⩾1 enzymes. A marginally statistically significant gradient in sensitisation across the exposure categories was found (p = 0.09). There was a clinical case of occupational asthma and two others 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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  • Funding This study was supported by the company. A contract guaranteed independence of the research group according to criteria set by the Dutch Royal Academy of Sciences (KNAW) in close collaboration with the occupational health service.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.