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Enzymes

Super Categories

All Agents
- High Molecular Weight Agents
  - Enzymes

Subcategories

amylase

Known Synonyms

None

Authors

Vicky Moore, Oasys Vicky Moore

Enzymes include those found in food processing such as baking (amylase), but also those found in washing detergents (protease, amylase, lipase and cellulase) and can sometimes be found in cleaning/sterlising agents. Enzymes are high molecular weight agents that tend to exert an IgE mediated allergic response. Alkaline and heat stable proteolytic enzymes were introduced into detergent products in the 1960's to improve the performance of the detergent via their ability to hydrolyse proteins embedded in fabrics. Occupational asthma associated with the use of proteolytic enzymes in the manufacture of detergents was first reported by Flindt and Pepys in 1969. The medical community rapidly recognised the risk of allergic antibody-mediated occupational asthma associated with enzyme exposure use as well as during the manufacture of enzymes. The first enzyme to be associated with adverse respiratory health effects was a serine protease derived from Bacillus species. Progress has been made in the reduction of the health risks associated with occupational exposure to enzymes. Methods used include the encapsulation of the enzymes and improved hygiene at manufacturing sites. Although evidence suggests that a reduction of new cases of occupational asthma has been associated with better containment of the enzymes via encapsulation and improved hygiene, the development of occupational asthma has continued to be a hazard.

Agent	Enzymes
Other Names	Protease, amylase, lipase, cellulase
Sources of Exposure	Detergents, Baking products, cleaning/sterlising agents
Jobs	Detergent manufacturers, warehouse workers, bakers, cleaners, hospital staff.
Epidemiological Studies	8.8% developed clinical enzyme allergy during the first three years of employment at Novo Nordisk A/S. The frequency of enzyme sensitisation, expressed as RAST values > 0.5 SU, was 36%, and the frequency of significant RAST values > or = 2 SU was 8%. Sensitisation occurred to all types of enzymes handled in the plant, most often in production areas and laboratories. A cross sectional study of 173 employees exposed to industrial enzymes in Finnish enzyme production and in Finnish laboratories showed 21 employees to be skin prick test positive to one or more enzymes. Sixteen positive persons also had specific immunoglobulin E. There is evidence of an association between detergent enzyme exposure level and the development of respiratory disease in an occupational setting. Links to papers at bottom of page.
Air Measurements	Available. In one study, lower respiratory disease was significantly elevated in those employees working in jobs in the highest quartile of protease exposure (geometric mean 7.9 ng.m–3). For employees with upper respiratory disease, the risk was significantly elevated at a lower level of estimated protease exposure (geometric mean 2.3 ng.m–3). Long term exposure limits: 10mg/m³
Specific IgE/ Skin prick test	Available
Biological Monitoring	Possible through monitoring specific IgE levels. If levels fall, relocation is likely to be successful.
Specific Challenge	Methods are based on tipping the dust from one container to another. Enzymes can be mixed with an inert substance such as lactose to get different concentrations.
Early References	Pepys J, Hargreave FE, Longbottom JL, Faux J , Allergic reactions of the lungs to enzymes of bacillus subtelis , Lancet , 1969 ; i : 1181-1184. Flindt MLH , Pulmonary disease due to inhalation of derivatives of Bacillus subtelis containing proteolytic enzymes , Lancet , 1969 ; i : 1177-1181
Substitutes	No substitutes, encapsulation of the enzymes has decreased exposure but not eliminated it.

	See published papers on "Enzymes" from this website.

	See information on "Enzymes" from the HazMap (Information on Hazardous Chemicals and Occupational Diseases) website.
	See information on "Enzymes" from the AsmaPro website (database of occupational asthma cases).

Oasys Notifications for Enzymes

The Oasys Audit scheme started midway through 2010 and collects agents typed in through the Oasys program. The years before 2010 show old data entered during 2010 or later and are likely to have many fewer notifications. We expect Oasys to become more widely adopted as time goes by so increasing notifications does not necessarily mean an increasing problem.

Occupational asthma notifications to the Oasys Audit Scheme for Enzymes

Selected References for Enzymes

	van Rooy FGBGJ, Houba R, Palmen N, Zengeni MM, Sander I, Spithoven J, Rooyackers JM, Heederik DJJ, A cross-sectional study among detergent workers exposed to liquid detergent enzymes, Occup Environ Med, 2009;66:759-765,

	Brant A, Upchurch S, van Tongeren M, Zekveld C, Helm J, Barnes F, Newman Taylor AJ, Cullinan P, Detergent protease exposure and respiratory disease: case-referent analysis of a retrospective cohort, Occup Environ Med, 2009;66:754-758,

	Moore VC, Cullinan P, Sadhra S, Burge PS, Peak expiratory flow analysis in workers exposed to detergent enzymes, Occup Med, 2009;59:418-423,

	Heederik D, van Rooy FGBGJ, Exposure assessment should be integrated in studies on the prevention and management of occupational asthma, Occup Environ Med, 2008;65:149-150,

	Cullinan P, Occupational asthma, Occup Environ Med, 2008;65:151-151,

	Sripaiboonkij P, Phanprasit W, Jaakkola MS, Respiratory effects of occupational exposures in a milk powder factory, Eur Respir J, 2008;31:807-814,

	Larsen AI, Johnsen CR, Frickmann J, Mikkelsen S, Incidence of respiratory sensitisation and allergy to enzymes among employees in an enzyme producing plant and the relation to exposure and host factors , Occup Environ Med, 2007;64:763-768,

	Sander I, Zahradnik E, Raulf-Heimsoth M, Wouters IM, Renström A, Harris-Roberts J, Robinson E, Rodrigo MJ, Goldscheid N, Brüning T, Doekes G, Optimized methods for fungal a-amylase airborne exposure assessment in bakeries and mills , Clin Exp Allergy, 2007;37:1229-1238,

	Cullinan P, Harris JM, NewmanTaylor AJ et al, An Outbreak Of Asthma In A Modern Detergent Factory, Lancet, 2000;356:1899-1900,

	Kim HY, Nahm DH, Park HS, Choi DC, Occupational asthma and IgE sensitization to cellulase in a textile industry worker, Ann Allergy Asthma Immunol, 1999;82:174-178,

	Baur X, Posch A, Characterized allergens causing bakers' asthma. [Review], Allergy, 1998;53:562-566,

	Sander I, NeuhausSchroder C, RaulfHeimsoth M, Doekes G, Heederik D, Baur X, Quantification of inhaled exposure to alpha-amylase in 2 bakeries, Pneumologie, 1998;52:440-443,

	Houba R, Van Run P, Doekes G, Heederik D, Spithoven J, Airborne levels of alpha-amylase allergens in bakeries., J Allergy Clin Immunol, 1997;99:286-292,

	Johnsen CR, Sorensen TB, Ingemann Larsen A et al, Allergy risk in an enzyme producing plant: a retrospective follow up study, J Occup Environ Med, 1997;54:671-675,

	Cathcart M, Nicholson P, Roberts D, Bazley M, Juniper C, Murray P, Randell M, Enzyme exposure, smoking and lung function in employees in the detergent industry over 20 years. Medical Subcommittee of the UK Soap and Detergent Industry Association, Occup Med (London), 1997;47:473-478,

	Wiley K, Smith MM, Allan LJ, Griffin P, Measurement of airborne flour exposure with a monoclonal antibody-based immunoassay, Int Arch Allergy Immunol, 1997;114:278-284,

	Vanhanen M, Tuomi T, Nordman H et al, Sensitisation to industrial enzymes in enzyme research and production, Scand J Work Environ Health, 1997;23:385-391,

	Flindt ML, Biological miracles and misadventures: identification of sensitization and asthma in enzyme detergent workers, Am J Ind Med, 1996;29:99-110,

	Houba R, Heederik DJ, Doekes G, van Run PE, Exposure-sensitisation relationship for alpha-amylase allergens in the baking industry, Am J Respir Crit Care Med, 1996;154:130-136,

	Laraqui C, Harourate K, Belamallem I, Benhaymoud N, Verger C, Occupational respiratory risks in workers exposed to enzymes in detergents, Rev Mal Respir, 1996;13:485-492,

	Houba R, Van Run P, Heederik D, Doekes G, Wheat antigen exposure assessment for epidemiological studies in bakeries using personal dust sampling and inhibition ELISA, Clin Exp Allergy, 1996;26:154-163,

	Baur X, Sander I, Jansen A, Czuppon AB, Are amylases in bakery products and flour potential food allergens?, Schweiz Med Wochenschr, 1994;124:846-851,

	Perdu D, Lavaud F, Cossart C, Legrele S, Passemard F, Deltour G, Dubois de Montreynaud JM, Detergent enzymes: has the risk of occupational sensitization disappeared?., Rev Mal Respir, 1992;9:443-448,

	Losada E, Hinojosa M, Quirce S, SanchezCano M, Moneo I, Occupational asthma caused by alpha-amylase inhalation: clinical and immunologic findings and bronchial response patterns, J Allergy Clin Immunol, 1992;89:118-125,

	Quirce S, Cuevas M, DiezGomez M, FernandezRivas M, Hinojosa M, Gonzalez R, Losada E, Respiratory allergy to Aspergillus-derived enzymes in bakers' asthma, J Allergy Clin Immunol, 1992;90:970-978,

	Barber D, SanchezMonge R, Gomez L, Carpizo J, Armentia A, LopezOtin C, Juan F, Salcedo G, A barley flour inhibitor of insect alpha-amylase is a major allergen associated with baker's asthma disease, FEBS Lett, 1989;248:119-122,

	Baur X, Sauer W, Weiss W, Baking additives as new allergens in bakers asthma, Respiration, 1988;54:70-72,

	Baur X, Fruhmann G, Haug B, Rasche B, Reiher W, Weiss W, Role of Aspergillus amylase in bakers asthma, Lancet, 1986;i:43-43,

	Flood DF, Blofeld RE, Bruce CF et al, Lung function, atopy, specific hypersensitivity, and smoking of workers in the enzyme detergent industry over 11 years, Br J Ind Med, 1985;42:43-50,

	Hartmann AL, Wuthrich B, Baur X, Asthma due to enzymes, Schweiz Med Wochenschr, 1984;114:916-917,

	Juniper CP, Roberts DM, Enzyme asthma: fourteen years clinical experience of a recently prescribed disease, J Soc Occup Med, 1984;34:126-132,

	Liss GM, Kominsky JR, Gallagher JS, Melius J, Brooks SM, Bernstein IL, Failure of enzyme encapsulation to prevent sensitisation of workers in the dry bleach industry, J Allergy Clin Immunol, 1984;73:348-355,

	Flindt MLH, Variables affecting the outcome of inhalation of enzyme dusts, Ann Occup Hyg, 1982;26:647-655,

	Zachariae H, H0X/eghThomsen J, Witmeur O, Wide L, Detergent enzymes and occupational safety, Allergy, 1981;36:513-516,

	How MJ, Goodwin BFJ, Juniper CP, Kinshott AK, Comparitive serological and clinical findings in subjects exposed to environmental allergens, Clin Allergy, 1978;8:347-360,

	Zetterstrom O, Dual skin test reactions and serum antibodies to subtilisin and Aspergillus fumigatus extracts, Clin Allergy, 1978;8:77-91,

	Zetterstrom O, Challenge and exposure test reactions to enzyme detergents in subjects sensitised to subtilisin, Clin Allergy, 1977;7:355-363,

	Peters G, Mackenzie DP, Worker safety: how to establish site enzyme capability, Enzymes in Detergency, 1977;1:327-340,

	Medical Research Council, Biological effects of proteolytic enzyme detergents, Thorax, 1976;31:621-634,

	Musk AW, Gandevia B, Loss of pulmonary elastic recoil in workers formerly exposed to proteolytic enzyme (alcalase) in the detergent industry, Brit J Industr Med, 1976;33:158-165,

	Zapeda AG, Procel EG, Quiroga EHG, Vargas MM, Torres LM, Occupational asthma from inhaling proteolytic enzymes, Rev Med Inst Mex Seg, 1975;14:131-137,

	Weill H, Waggenspack C, DeRouen T, Ziskind M, Follow-up observations on workers exposed to enzyme detergents, Ann N Y Acad Sci, 1974;221:76-85,

	Bernstein IL, Enzyme allergy in populations exposed to long-term, low level concentrations of household laundry products, J Allergy Clin Immunol, 1971;49:219-237,

	Mitchell CA, Gandevia B, Respiratory symptoms and skin reactivity in workers exposed to proteolytic enzymes in the detergent industry, Am Rev Respir Dis, 1971;104:1-12,

	Greenberg M, Milne JF, Watt A, Survey of workers exposed to dusts containing derivatives of Bacillus subtilis, Br Med J, 1970;2:629-633,

	Flindt MLH, Pulmonary disease due to inhalation of derivatives of Bacillus subtelis containing proteolytic enzymes, Lancet, 1969;i:1177-1181,

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