Which agents cause occupational asthma and which workers are at risk?

The following references have been associated with this question by users of this website. They do not form part of the BOHRF occupational asthma guidelines.

burgeps Orriols 2006
Cedd Burge Vellore 2006 Isoflurane and Sevoflurane have been identified as agents causing Occupational Asthma. 1 patient had positive broncial challenge to isoflurane and sevoflurane. The second patient had specific bronchial challenge to isoflurane. The third patient had a significant change in methacholine reactivity after ceasing exposure to isoflurane.
burgeps Murray 1957 Tamarind seed size caused symptoms needing time off work in 30% exposed weavers. The symptoms stopped when an alternative size was reintroduced.
burgeps Bernsefa 2004 Greater reactions to rye than wheat, but order of tests unclear, diffrences could be due to rye challenge following wheat challenge. Both provoked asthma
burgeps Labrecque 2004 1/2 workers with positive challenge had normal NSBR before and after challenge (but no very recent exposure before the challenge) An extract of pork mean illicited an immediate asthmatic reaction in one, the other had a positive workplace challenge
burgeps Cavagna 1966
burgeps Dawkins 2006 The paper is mostly about extrinsic allergic alveolitis, but 6/12 had symptomic wheeze in addition to evidence of EAA, 5 had peak flow diurnal variability >20% and 4 had an Oasys score >2.5. It is likely that some of the 12 had both occupational asthma and alveolitis. A subsequent (as yet ubpublished) epidemiological study showed a much larger number of workers with occupational asthma from the same plant. Aerosols from metal-working fluid were the most likely cause
burgeps Hannu 2007 stainless steelwelding fume with specific challenge tests
Cedd Burge Robertson 2007 Paper documents aerosols from metal working fluid as a cause of occupational asthma.
burgeps Suuronen 2007 Metal-working fluid cases from the Finnish registry; only workers who react to sgents in unused oil or to other agents in the workplace seem to be included. Incidence 0.2/1000 worker.years (includes 1 alveolitis and 4 rhinitis)
burgeps Larsen 2007 Manufactureres of enzymes are at risk. A study of manufacturers of a mixed (and unspecified) group of enzymes studied prospectively. The incidence of sensitisation and disease was measured for the first 3 years of exposure only. The incidence for sensitisation was 0.13/person year at risk and for disease (asthma, rhinitis or urticaria) 0.03/person year at risk. There was no relationship betweem measured exposure and incidence, but incidence reduced over time (1970-2002), during which time more atopics were employed. Atopy was a risk factor for sensitisation but not disease, smoking was a risk factor for disease and sensitisation (x2). It is likely that the air measurement did not fully represent exposures, and that the initial exclusion of atopics was a confouding factor. Within the first 3 years 10-5% developed disease (decreasing over time); of those with disease 55% had asthma.
burgeps Tran 2007 Hydroxylamine replaced glutaraldehyde for deinking recycled paper. 3 cases found with positive challenge in one to a new cause.
burgeps Pronk 2007 Epidemiological study showing increased respiratort symptoms with increasing exposure to isocyanate pre-polymers based on HDI (oligomers, HDI biuret, HDI isocyanurate)
burgeps Hannu 2008 Handling Ivy in a florist caused asthma, rhinitis and urticaria with positive challenge
burgeps Haahtela 2008 Exercise induces asthma which can be eosinophilic or non-eosinophilic with similar outcomes to allergic occupational asthma
burgeps Palomares 2008
burgeps Quirce 2008
Beverly Nemery 1993
burgeps Foti 28 Crushing almond shells a cause of allergic occupational asthma despite the title (not IgE mediated)
burgeps Vandenplas 2008 Chamomile dust established as cause of occupationa astm, this should revise previous statements that chmomile dust is ony a non-specific irritant in tea packers
burgeps Vandenplas 2008 Positive challenge to linseed oil cake in a research chemist with suitable negative controls. Supports previous studies
burgeps Vellore 2008 This paper suggest that the chemical structures of low molecular weight vitamins have features which would suggest allergenicity if inhaled.
burgeps Vandenplas 2008 good evidence of cause and effect
burgeps Munoz 2007
burgeps Cruz 2006
burgeps Munoz 2006
burgeps Munoz 2003
Nelson Teixeira Jr American 1995
burgeps J.-Y. 2006
burgeps Moscato 2005
burgeps Olin 2004
Cedd Burge Moore 2009 Good cause and effect for gel flux containing dodecanedioic.
Tony knott Marquart 1989 Where can i get a printed sheet on the does and dont's of welding zinc coated steelsdoes it need a risk assment
Vicky Moore Adewole 2009 Evidence that diesel exhause exposure can cause occupational asthma.
burgeps McCoach 1999 Floor cleaning agents are a cause of occupational asthma in those whose rooms are cleaned as well as the cleaners themselves
burgeps Walusiak 2002 mitoxantrone caused occupational asthma with latency in an oncology nurse with positive specific challenge
burgeps Lluch-Pérez 2009 Marigold flour used in animal feed (to produce more coloured meet) a new cause of occupational asthma
burgeps Rosado 2009 Cooking octopus in a canning factory a new cause of occupational asthma, possibly caused by tropomyosin
burgeps Choi 2009 Vancomycin manufacture a cause of occupational asthma
burgeps Miedinger 2009 malt a cause of occupational asthma as well as alveolitis in a maltster
burgeps Gomez-Olles 2010 Challenge positive case report of a pharmaceutical warehouseman
burgeps Cherry 2009 Population study of asthma incidence showing increased rates in male cleaners, and workers exposed to isocyanates and agriculural agents
burgeps Anees 2011 Heated TGIC shown to cause occupational asthma with specific challenge tests
burgeps Mäkelä 2011 Challenge series from Finland identifying ethanolamines and chloramine T as well as Aspergillus species as causes of asathma in cleaners
burgeps Lietzén 2011 This prospective study in Finland finds that severe conflict with a supervisor at work is associated with new onset asthma within the 2 years after the stress was identified by questionnaire. The hazard ratio was about 1.61 similar to divorce or separation (1.65) or a major increase in marital problems (1.62), and more than dealth of a father or mother or violence. The life stressors were additive. This is the best evidence that stress at work might cause asthma.
burgeps Burton 2011 At least one good challenge positive case with negative formaldehyde challenge
burgeps Hayes 1991 styrene establised as a cause of occupational asthma by specific provocation testing
burgeps Pahr 2012 This study shows that the allergens responsible for bakers asthma are genereally different from those resonsible for wheat food allergy. The occupational allergens are mainly 1-Cys-peroxiredoxin and glutsthione transferase, dehydrin was less specific
burgeps Paris 2012 This paper provides the best evidence from an industrialised country that occupational asthma,at least from some causes, is on the decline. The strength of the study include the compulsory notification of referrals to all the university occupational lung referral centres in France. The relative proportion of notifications for the main agents overcomes some of the problems of referral and reporter bias, but cannot differentiate between exposures which have been brought under control, and those exported to other countries. Latex and aldehydes are two health-care related agents on the decline, as found in several other studies, but isocyanate asthma is also on the decline. Occupational asthma in hairdressers is static, and cleaning agents as a cause of occupational asthma is on the increase.
burgeps Wittczak 2012 First case report of specific IgE to spruce wood
burgeps Walters 2012 Chrome occupational asthma can occur from machining stainless steel alloys, the chrome being present in airosolised metal-working fluid. Cpbalt can cause similar problems
burgeps Angulo 2011 Agent Erythromycin ethyl succinate Job Pharmaceutical packer Specific IgE neg Skin prick test not done Non-specific reactivity Increased after SIC, values not given Serial Peak Flow Done, said to show asthma without work effect BAL Not done FENO Not done Basophil histamine release Not done Specific Challenge positive late reaction Follow-up Relocated, improved, no details
burgeps Siracusa 2013
burgeps Walters 2014 The paper describes an outbreak of occupational asthma in a factory manufacturing car engine valves which contained a stellite weld to improve hardiness. This was later ground using metal-working fluid. The metal working fluid dissolved some of the cobalt from the stellite which sensitised workers not directly working with stellite containing valves after all machines were connected to a common sump. Cobalt was shown to be the cause by specific inhalation tests and skin prick tests. The lack of acceptance of cobalt as the cause delayed control by over 10 years
burgeps Dumas 2014 Increased risk of asthma (not occupational asthma) found in a wide range of occupations including cleaning, healthcare, textile, hand packers, dairy/livestock, mechanics, electricians, drivers and building workers.
burgeps Vizcaya 2015 further evidence for adverse effects of cleaning agents, particularly if sprayed
burgeps Tafuro 2015 This study adds to research on the industries where storage mite allergy might occur. The paper describes one worker with work-related asthma symptoms, peak flow monitoring and positive IgE to storage mites, as well as 15 with occupational rhinitis (the denominator data are unclear). All those with storage mite IgE also reacted to house dust mites, but many of the controls reacted only to the house dust mites. Parma hams are produced by means of a long process that includes phases of salting, resting, washing and drying, and greasing and curing. By law, Parma ham is cured by hanging the prepared haunches on racks for at least 1 year (and, in some cases, 3 years) after the date of first salting, in darkened, air-controlled cellars at a temperature of 15-23°C. These conditions favour the formation of a soft surface patina of white mould and mites, which are indispensable for the development of the typical aroma. The arthropods that settle on the surface of a ham include Tyrophagus putrescentiae, Acarus siro and Lepidoglyphus destructor.
burgeps Paris 2015 Good evidence of a new cause of occupational asthma from Argan, derived from the nuts of the tree. It is used in cosmetics. All 9 exposed workers had positive skin prick tests, 3 had positive immediate asthmatic reactions during challenge tests, and one rhinitis. The allergens cross-reacted with hazel nut allergens.
burgeps Nam 2012 This is the first report of sprayed sodium hypochlorite giving a positive challenge test. There is no control exposure in the patient or asymptomatic controls
burgeps Jones 2016
burgeps Budnik 2017 This study shows that genetically modified enzymes in widespread use cause IgE-related sensitisation in exposed workers, and that there may be little cross-reaction with the naturally occuring unmodified enzymes
burgeps Fell 2016
burgeps Suresh 2016 This is a case report of a non-smoking gluer of cardboard boxes in an airospace factory with a history suggestive of occupational asthma and improved spirometry after leaving (no PEF's or challenge). I addition bronchoscopy showed an eosinophil BAL and lipid bacuoles in the bronchial walls and in macrophages. It is postulated that the lipid came from the glue.
burgeps Walters 2017 triclosan, Antibac, (2,4,4’-trichloro-2’-hydroxydiphenyl ether), established as a new cause of occupational asthma with positive SIC and Oasys records
burgeps Moore 2017 This is a key paper showing that chlorine-releasing cleaning agents may cause sensitising type occupational asthma by producing chloramines, and that a protein source as well as the chlorine is required
burgeps Jones 2017 Clear dose-response to exposure to the fruit fly in laboratory workers
burgeps Walters 2017
burgeps House 2017 no specific challenge
burgeps Vandenplas 2017 New cause of occupational asthma with positive SIC (late reaction), increase in NSBR and FeNO post challenge and hazard index 0.49. No monitoring at work, laying epoxy surfaces over concrete
burgeps Suojalehto 2018 Chemical intermediate in horticulture. 25% sensitised in production hall. SIC positive at 0.03-0.3%
burgeps Torrijos 2018 Positive intradermal test, no PFT
burgeps Madsen 2019
burgeps Walters 2019
burgeps Jeebhay 2019 good review of causes of occupational asthma due to foods
burgeps Weinmann 2019
burgeps Brock 2019
burgeps Suojalehto 2019 Good collection of OA from Europe showing that acrylic OA has the features of an IgE type with raised FeNO and more rhinitis than isocyanates. As far as I know there are no successful studies identifying specific IgE to acrylates
burgeps Lozewicz 1985

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