Enzymes

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Known Synonyms

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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.

References for: Enzymes See published papers on "Enzymes" from this website.
Haz-Map information on: Enzymes See information on "Enzymes" from the HazMap (Information on Hazardous Chemicals and Occupational Diseases) website.
Asmanet information on: Enzymes 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

Abstract Available for A cross-sectional study among detergent workers exposed to liquid detergent 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,
Dick Heederik, Institute of Risk Assessment Sciences, Utrecht, an author of 'A cross-sectional study among detergent workers exposed to liquid detergent enzymes' Frits van Rooy, Utrecht University, an author of 'A cross-sectional study among detergent workers exposed to liquid detergent enzymes'

Abstract Available for Detergent protease exposure and respiratory disease: case-referent analysis of a retrospective cohort 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,
Paul Cullinan, Royal Brompton Hospital, London, UK, an author of 'Detergent protease exposure and respiratory disease: case-referent analysis of a retrospective cohort' Tony Newman Taylor, Royal Brompton Hospital, London, an author of 'Detergent protease exposure and respiratory disease: case-referent analysis of a retrospective cohort'

Full Text Available for Peak expiratory flow analysis in workers exposed to detergent enzymes Moore VC, Cullinan P, Sadhra S, Burge PS, Peak expiratory flow analysis in workers exposed to detergent enzymes, Occup Med, 2009;59:418-423,
Paul Cullinan, Royal Brompton Hospital, London, UK, an author of 'Peak expiratory flow analysis in workers exposed to detergent enzymes' Sherwood Burge, Oasys, an author of 'Peak expiratory flow analysis in workers exposed to detergent enzymes' Vicky Moore, Oasys, an author of 'Peak expiratory flow analysis in workers exposed to detergent enzymes'

Full Text Available for Exposure assessment should be integrated in studies on the prevention and management of occupational asthma 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,
Dick Heederik, Institute of Risk Assessment Sciences, Utrecht, an author of 'Exposure assessment should be integrated in studies on the prevention and management of occupational asthma' Frits van Rooy, Utrecht University, an author of 'Exposure assessment should be integrated in studies on the prevention and management of occupational asthma'

Full Text Available for Occupational asthma Cullinan P, Occupational asthma, Occup Environ Med, 2008;65:151-151,
Paul Cullinan, Royal Brompton Hospital, London, UK, an author of 'Occupational asthma'

Full Text Available for Respiratory effects of occupational exposures in a milk powder factory Sripaiboonkij P, Phanprasit W, Jaakkola MS, Respiratory effects of occupational exposures in a milk powder factory, Eur Respir J, 2008;31:807-814,
Maritta Jaakkola, Oulu University Finland, an author of 'Respiratory effects of occupational exposures in a milk powder factory'

Full Text Available for Incidence of respiratory sensitisation and allergy to enzymes among employees in an enzyme producing plant and the relation to exposure and host factors 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,

Abstract Available for Optimized methods for fungal a-amylase airborne exposure assessment in bakeries and mills 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,
Joanne Harris-Roberts (nee Elms), HSL, Buxton, UK, an author of 'Optimized methods for fungal a-amylase airborne exposure assessment in bakeries and mills' Ed Robinson, Health and Safety Laboratories, Buxton, UK, an author of 'Optimized methods for fungal a-amylase airborne exposure assessment in bakeries and mills' Monika Raulf-Heimsoth, Bochum, an author of 'Optimized methods for fungal a-amylase airborne exposure assessment in bakeries and mills'

Abstract Available for An Outbreak Of Asthma In A Modern Detergent Factory Cullinan P, Harris JM, NewmanTaylor AJ et al, An Outbreak Of Asthma In A Modern Detergent Factory, Lancet, 2000;356:1899-1900,
Paul Cullinan, Royal Brompton Hospital, London, UK, an author of 'An Outbreak Of Asthma In A Modern Detergent Factory' Jessica Harris, Royal Brompton Hospital, an author of 'An Outbreak Of Asthma In A Modern Detergent Factory'

Abstract Available for Occupational asthma and IgE sensitization to cellulase in a textile industry worker 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,
Hae-Sim Park, Korea, an author of 'Occupational asthma and IgE sensitization to cellulase in a textile industry worker'

Abstract Available for Characterized allergens causing bakers' asthma. [Review] Baur X, Posch A, Characterized allergens causing bakers' asthma. [Review], Allergy, 1998;53:562-566,
Xaver Baur, Institute of occupational medicine, Hamburg, an author of 'Characterized allergens causing bakers' asthma. [Review]'

Abstract Available for Quantification of inhaled exposure to alpha-amylase in 2 bakeries 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,
Dick Heederik, Institute of Risk Assessment Sciences, Utrecht, an author of 'Quantification of inhaled exposure to alpha-amylase in 2 bakeries' Xaver Baur, Institute of occupational medicine, Hamburg, an author of 'Quantification of inhaled exposure to alpha-amylase in 2 bakeries'

Abstract Available for Airborne levels of alpha-amylase allergens in bakeries. 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,
Dick Heederik, Institute of Risk Assessment Sciences, Utrecht, an author of 'Airborne levels of alpha-amylase allergens in bakeries.'

Abstract Available for Allergy risk in an enzyme producing plant: a retrospective follow up study 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,

Full Text Available for 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 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,
Paul Nicholson, Procter And Gamble Occupational Health, an author of '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'

Abstract Available for Measurement of airborne flour exposure with a monoclonal antibody-based immunoassay 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,

Abstract Available for Sensitisation to industrial enzymes in enzyme research and production 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,
Henrik Nordman, Finnsh Institute of Occupational Health, an author of 'Sensitisation to industrial enzymes in enzyme research and production'

Abstract Available for Biological miracles and misadventures: identification of sensitization and asthma in enzyme detergent workers Flindt ML, Biological miracles and misadventures: identification of sensitization and asthma in enzyme detergent workers, Am J Ind Med, 1996;29:99-110,
Michael Flindt, Manchester, an author of 'Biological miracles and misadventures: identification of sensitization and asthma in enzyme detergent workers'

Abstract Available for Exposure-sensitisation relationship for alpha-amylase allergens in the baking industry 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,
Dick Heederik, Institute of Risk Assessment Sciences, Utrecht, an author of 'Exposure-sensitisation relationship for alpha-amylase allergens in the baking industry'

Abstract Available for Occupational respiratory risks in workers exposed to enzymes in detergents 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,

Abstract Available for Wheat antigen exposure assessment for epidemiological studies in bakeries using personal dust sampling and inhibition ELISA 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,
Dick Heederik, Institute of Risk Assessment Sciences, Utrecht, an author of 'Wheat antigen exposure assessment for epidemiological studies in bakeries using personal dust sampling and inhibition ELISA'

Abstract Available for Are amylases in bakery products and flour potential food allergens? 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,
Xaver Baur, Institute of occupational medicine, Hamburg, an author of 'Are amylases in bakery products and flour potential food allergens?'

Abstract Available for Detergent enzymes: has the risk of occupational sensitization disappeared?. 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,

Abstract Available for Occupational asthma caused by alpha-amylase inhalation: clinical and immunologic findings and bronchial response patterns 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,
Santiago Quirce, Madrid, an author of 'Occupational asthma caused by alpha-amylase inhalation: clinical and immunologic findings and bronchial response patterns'

Abstract Available for Respiratory allergy to Aspergillus-derived enzymes in bakers' asthma 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,
Santiago Quirce, Madrid, an author of 'Respiratory allergy to Aspergillus-derived enzymes in bakers' asthma'

No Abstract Available for A barley flour inhibitor of insect alpha-amylase is a major allergen associated with baker's asthma disease 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,

No Abstract Available for Baking additives as new allergens in bakers asthma Baur X, Sauer W, Weiss W, Baking additives as new allergens in bakers asthma, Respiration, 1988;54:70-72,
Xaver Baur, Institute of occupational medicine, Hamburg, an author of 'Baking additives as new allergens in bakers asthma'

No Abstract Available for Role of Aspergillus amylase in bakers asthma Baur X, Fruhmann G, Haug B, Rasche B, Reiher W, Weiss W, Role of Aspergillus amylase in bakers asthma, Lancet, 1986;i:43-43,
Xaver Baur, Institute of occupational medicine, Hamburg, an author of 'Role of Aspergillus amylase in bakers asthma'

Abstract Available for Lung function, atopy, specific hypersensitivity, and smoking of workers in the enzyme detergent industry over 11 years 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,

Abstract Available for Asthma due to enzymes Hartmann AL, Wuthrich B, Baur X, Asthma due to enzymes, Schweiz Med Wochenschr, 1984;114:916-917,
Xaver Baur, Institute of occupational medicine, Hamburg, an author of 'Asthma due to enzymes'

No Abstract Available for Enzyme asthma: fourteen years clinical experience of a recently prescribed disease Juniper CP, Roberts DM, Enzyme asthma: fourteen years clinical experience of a recently prescribed disease, J Soc Occup Med, 1984;34:126-132,

No Abstract Available for Failure of enzyme encapsulation to prevent sensitisation of workers in the dry bleach industry 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,
Stuart Brooks, University of South Florida, an author of 'Failure of enzyme encapsulation to prevent sensitisation of workers in the dry bleach industry' Leonard Bernstein, Cincinatti, an author of 'Failure of enzyme encapsulation to prevent sensitisation of workers in the dry bleach industry' Garry Liss, Toronto, an author of 'Failure of enzyme encapsulation to prevent sensitisation of workers in the dry bleach industry'

No Abstract Available for Variables affecting the outcome of inhalation of enzyme dusts Flindt MLH, Variables affecting the outcome of inhalation of enzyme dusts, Ann Occup Hyg, 1982;26:647-655,
Michael Flindt, Manchester, an author of 'Variables affecting the outcome of inhalation of enzyme dusts'

No Abstract Available for Detergent enzymes and occupational safety Zachariae H, H0X/eghThomsen J, Witmeur O, Wide L, Detergent enzymes and occupational safety, Allergy, 1981;36:513-516,

No Abstract Available for Comparitive serological and clinical findings in subjects exposed to environmental allergens 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,

No Abstract Available for Dual skin test reactions and serum antibodies to subtilisin and Aspergillus fumigatus extracts Zetterstrom O, Dual skin test reactions and serum antibodies to subtilisin and Aspergillus fumigatus extracts, Clin Allergy, 1978;8:77-91,

No Abstract Available for Challenge and exposure test reactions to enzyme detergents in subjects sensitised to subtilisin Zetterstrom O, Challenge and exposure test reactions to enzyme detergents in subjects sensitised to subtilisin, Clin Allergy, 1977;7:355-363,

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

No Abstract Available for Biological effects of proteolytic enzyme detergents Medical Research Council, Biological effects of proteolytic enzyme detergents, Thorax, 1976;31:621-634,

No Abstract Available for Loss of pulmonary elastic recoil in workers formerly exposed to proteolytic enzyme (alcalase) in the detergent industry 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,

No Abstract Available for Occupational asthma from inhaling proteolytic enzymes 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,

No Abstract Available for Follow-up observations on workers exposed to enzyme detergents 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,

No Abstract Available for Enzyme allergy in populations exposed to long-term, low level concentrations of household laundry products 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,
Leonard Bernstein, Cincinatti, an author of 'Enzyme allergy in populations exposed to long-term, low level concentrations of household laundry products'

No Abstract Available for Respiratory symptoms and skin reactivity in workers exposed to proteolytic enzymes in the detergent industry 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,

No Abstract Available for Survey of workers exposed to dusts containing derivatives of Bacillus subtilis Greenberg M, Milne JF, Watt A, Survey of workers exposed to dusts containing derivatives of Bacillus subtilis, Br Med J, 1970;2:629-633,

No Abstract Available for Pulmonary disease due to inhalation of derivatives of Bacillus subtelis containing proteolytic enzymes Flindt MLH, Pulmonary disease due to inhalation of derivatives of Bacillus subtelis containing proteolytic enzymes, Lancet, 1969;i:1177-1181,
Michael Flindt, Manchester, an author of 'Pulmonary disease due to inhalation of derivatives of Bacillus subtelis containing proteolytic enzymes'

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