chloramine-t and Asthma

The aim was to study the causes of respiratory hypersensitivity in dental personnel based on the statistics of the Finnish Register of Occupational Diseases (FROD; 1975-1998) and the patient material of the Finnish Institute of Occupational Health (FIOH; 1990-1998).. Details about the cases of respiratory hypersensitivity were compiled from the FROD. The occupational rhinitis diagnoses studied at the FIOH were based on work-related symptoms and a change in the status of the nasal mucosa during challenge testing; and the diagnosis of occupational asthma based on reactions in challenge testing, or on IgE positivity and peak flow monitoring at work and during days off.. A total of 64 cases of occupational respiratory diseases (ORDs) was diagnosed in dental personnel during 1975 to 1998 according to the FROD; two cases in 1975 to 1989, and 62 in 1990 to 1998. Twenty-eight cases were of occupational asthma (18 caused by methacrylates), 28 occupational rhinitis (six caused by methacrylates), seven allergic alveolitis and one organic dust toxic syndrome (ODTS). The non-acrylate-material diagnosed in 1990-1998 at the FIOH comprised three cases of asthma and one of rhinitis caused by chloramine-T (sodium- N-chlorine- p-toluene sulphonamide); as well as one case of asthma, seven cases of rhinitis, and two cases of combined rhinitis and conjunctivitis caused by natural rubber latex (NRL). Furthermore, one case of occupational rhinitis caused by Nobetec containing colophony was diagnosed. The incidence rate (IR) of ORD increased from 0 in 1988 to a peak of 105.1 new cases per 100,000 working years in 1995. During the last observation year, i.e. 1998, the IR was 55 new cases per 100,000 workers. The IR in dental personnel was lower than in the whole working population in Finland up until 1992, but since then has been greater than in the whole population, peaking in 1995 when the IR of dental personnel was 2.55 times greater than in the whole population.. The present study shows the increasing frequency of respiratory hypersensitivity among dental personnel. Besides methacrylates, important causes of respiratory hypersensitivity are NRL and chloramine-T.

Topics: Adult; Asthma; Chloramines; Dental Assistants; Dentists; Eugenol; Female; Finland; Humans; Latex Hypersensitivity; Male; Methacrylates; Middle Aged; Occupational Diseases; Periodontal Dressings; Respiratory Hypersensitivity; Rhinitis; Rhinitis, Allergic, Perennial; Tosyl Compounds

Little is known about the use of prick tests with chemicals in diagnosing occupational diseases.. To evaluate the use of prick tests in the diagnosis of occupational contact urticaria, asthma and rhinitis caused by chemicals (undertaken at the Finnish Institute of Occupational Health).. We retrospectively reviewed the patient and test files for the period 1 January 1991 to 31 May 2011. Prick tests were performed with chemical solutions and human serum albumin (HSA)-chemical conjugates.. Positive prick test reactions to isocyanate-HSA conjugates were associated with isocyanate-specific IgE in all 20 patients, and 17 patients had a relevant occupational disease. Positive reactions to chloramine-T-HSA conjugates in 10 patients also indicated the presence of specific IgE, although occupational diseases were not always diagnosed. Eleven of 17 patients with positive reactions to persulfate solutions were diagnosed with an occupational disease. Methacrylates, colophonium-related substances, amine hardeners, ethanolamines, glutaraldehyde, glyoxal, pyrocatechol and ammonium thioglycolate did not elicit any relevant prick test reactions. No generalized reactions were detected.. Prick tests can be safely used for diagnosing contact urticaria, asthma and rhinitis caused by isocyanates, chloramine-T, persulfates, and chlorhexidine, but the results should be carefully interpreted and related to clinical symptoms and other diagnostic tests.

Topics: Asthma; Chloramines; Chlorhexidine; Dermatitis, Contact; Dermatitis, Occupational; Humans; Isocyanates; Retrospective Studies; Rhinitis; Skin Tests; Sulfates; Tosyl Compounds; Urticaria

Several epidemiological studies have reported an increased risk of asthma among professional cleaners. To date, however, no analysis of large patient series from clinic of occupational medicine has been published.. To describe the cases of occupational asthma (OA) diagnosed at the Finnish Institute of Occupational Health (FIOH) during the period 1994-2004 in workers employed in professional cleaning work.. OA was diagnosed according to patient history, lung function examinations and specific challenge tests with measurements of the forced expiratory volume in 1 second and peak expiratory flow values.. Our series comprised 20 patients, all female, with a mean age of 48.8 years (range 27-60 years). The mean duration of cleaning work before the onset of the respiratory symptoms was 14.3 years (range 1-36 years), and the mean duration of cleaning work before the FIOH examinations was 18.6 years (range 3-38 years). OA was triggered by chemicals in 9 cases (45%) and by moulds in 11 cases (55%). The chemicals were cleaning chemicals (wax-removing substances containing ethanolamines in five cases and a cleaning agent containing chloramine-T in one case) and chemicals used in the industrial processes at workplaces (three cases). Of the moulds, the most frequently associated with OA was Aspergillus fumigatus (nine cases).. OA was attributed not only to cleaning chemicals but also to other chemicals used in work environments. Moulds are presented as a new cause of OA in cleaners.

Topics: Adult; Aspergillus fumigatus; Asthma; Chloramines; Detergents; Disinfectants; Ethanolamines; Female; Finland; Forced Expiratory Volume; Humans; Middle Aged; Mitosporic Fungi; Occupational Diseases; Occupational Exposure; Peak Expiratory Flow Rate; Spirometry; Tosyl Compounds; Vital Capacity

Topics: Adult; Air Pollutants, Occupational; Asthma; Chloramines; Disinfectants; Female; Humans; Occupational Diseases; Swimming Pools; Tosyl Compounds

Topics: Adult; Asthma; Bronchial Provocation Tests; Chloramines; Disinfectants; Female; Humans; Middle Aged; Occupational Exposure; Personnel, Hospital; Respiratory Hypersensitivity; Rhinitis, Allergic, Perennial; Skin Tests; Tosyl Compounds

Chloramine-T is a small molecular oxidizing agent that has been widely used as a disinfectant since the beginning of this century. It is generally used in a 5% solution but it is also supplied in powder form. Sporadic case reports of immediate-type sensitization to this agent associated with symptoms of asthma, rhinitis and urticaria have appeared during recent decades. In one of the reports, specific IgE antibodies in sera of four patients who developed asthmatic symptoms after exposure to chloramine-T were demonstrated using a radioimmuno-assay. Three cases of bronchial asthma in workers who had handled chloramine-T powder are described in the present report. Positive skin-prick test reactions to chloramine-T were observed and specific IgE antibodies to human serum albumin treated with chloramine-T were detected using the classic radioallergosorbent (RAST) technique in all three patients.

Topics: Adult; Antibodies, Anti-Idiotypic; Asthma; Chloramines; Disinfectants; Female; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Male; Middle Aged; Occupational Diseases; Radioallergosorbent Test; Skin Tests; Tosyl Compounds

Topics: Asthma; Chloramines; Disinfectants; Female; Humans; Immunoglobulin E; Insurance Claim Reporting; Middle Aged; Occupational Diseases; Sweden; Tosyl Compounds; Workers' Compensation

In the sera of patients who developed asthmatic symptoms after exposure to chloramine-T, specific IgE antibodies are demonstrated by a polystyrene tube radioimmunoassay. These antibodies are directed against human serum albumin treated with chloramine-T. Specific antibodies of subclasses IgG1, IgG3 and IgG4 were not found. Histamine release in response to chloramine-T-treated human serum albumin was demonstrated using the peripheral blood leukocytes of one of the patients. To define the antigenic determinant to which the specific IgE antibodies are directed, radioimmunoassay and radioimmunoassay-inhibition studies were performed using several autologous and heterologous chloramine-T-treated proteins. Moreover, the inhibition capacities of chloramine-T and structurally related compounds were also determined. The results of these experiments indicate that the antigenic determinant is formed, at least in part, by the p-toluenesulfonyl group of the chloramine-T molecule.

Topics: Adult; Antibody Specificity; Asthma; Binding Sites, Antibody; Chloramines; Epitopes; Female; Histamine Release; Humans; Immunoglobulin E; Immunoglobulin G; Male; Occupational Diseases; Radioallergosorbent Test; Radioimmunoassay; Serum Albumin; Tosyl Compounds

Respiratory symptoms developed in 5 patients who were exposed to chloramine-T, a potent disinfectant used in cleaning butcheries, kitchens, and operating theaters. Skin tests, performed in 4 patients, showed an immediate type of wheal and flare reaction followed by a late-type infiltrative reaction. In 3 patients, inhalation tests with chloramine-T were done. 1 patient showed asthmatic bronchial obstruction, immediately after inhalation, followed by a late-type asthmatic reaction after some hours. 2 patients only exhibited late-type reactions, 4-8 h after challenge. The late bronchial response lasted for several hours or even days and was accompanied by leukocytosis in all 3 patients and a slight fever in 1 patient. No evidence of alveolar involvement appeared. Pre-challenge inhalation of cromoglycate in 1 patient ameliorated the late response considerably.

Topics: Administration, Intranasal; Adult; Asthma; Bronchial Provocation Tests; Chloramines; Cromolyn Sodium; Female; Forced Expiratory Volume; Humans; Male; Occupational Diseases; Radiography, Thoracic; Respiratory Function Tests; Skin Tests; Time Factors; Tosyl Compounds