Occupational Asthma Reference

Labrecque M, Coté J, Cartier A, Lemière C, Malo J-L., Occupational asthma due to pork antigens, Allergy, 2004;59:893-893,
(Plain text: Labrecque M, Cote J, Cartier A, Lemiere C, Malo J-L., Occupational asthma due to pork antigens, Allergy)

Keywords:

Known Authors

André Cartier, Hôpital de Sacré Coeur, Montreal, Quebec, Canada André Cartier

Jean-Luc Malo, Hôpital de Sacré Coeur, Montreal, Quebec, Canada Jean-Luc Malo

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Abstract

We describe two cases of occupational asthma (OA) in workers processing pork meat confirmed by specific inhalation challenges. Animal proteins are a part of the high-molecular weight agents that frequently causes OA (1). In the pork animal, swine confinement facility workers often develop respiratory problems (2, 3) these complaints are less frequent in meat pork-processing plants where the environmental conditions are different. The following report describes two cases of (OA) pork antigen in a meat pork industry.

Both cases were male (33 and 49 years.), atopic and employed in a meat pork-processing plant for 1 and 11 years (subjects A and B) with no previous history of atopy. They were working on the production line, cutting up quarters of pork. After 6 months (subject A) and 11 years (subject B), both developed cough and attacks of wheezing and dyspnea, after starting work on the production line and getting worse at the end of the day. When seen in the clinic, both had been off work for several weeks and almost asymptomatics. Both subjects had a positive skin-prick test (10 and 5 mm) to an extract of pork meat antigen (Hollister-Stier Laboratories, Spokane, WA, USA). Subject A had normal forced expiratory volume (FEV1, 4.85 l) and borderline bronchial responsiveness with PC20 methacholine of 8.65 mg/ml. A bronchial challenge with nebulized pork meat antigen elicited an early response with 30% fall in FEV1 and no change in PC20 (Fig. 1). Subject B had also a normal FEV1 (3.14 l) and mild bronchial hyperresponsiveness (PC20 5 mg/ml). Monitoring of FEV1 at work confirmed the diagnosis of OA with an early response (FEV1 fell by 24% after 45 min of exposition with recovery over 2 h) . Patients were removed from their workplace with improvement in their symptomatology.

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Associated Questions

Registered users of this website have associated this reference with the following questions. This association is not a part of the BOHRF occupational asthma guidelines.

What are the sensitivity and the specificity of a normal measurement of non-specific reactivity while at work in the diagnosis of occupational asthma?
burgeps 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
Which agents cause occupational asthma and which workers are at risk?
burgeps 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

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Comments

Agent
Pork meat
Job
Meat processors (butchers) cutting up pork quarters (2)
Proof
Specific IgE not tested
Skin prick test to pork meat (Hollister-Stier) positive 5 and 10 mm)
Non specific bronchial reactivity normal and unchanged by challenge (1/1); reactive before challenge 1/2
Serial peak flow records not done 2/2
Specific Bronchial Challenge: immediate reaction to nebulised pork meat extract (concentration not stated) 1/1. Control (unspecified) negative
Positive immediate workplace challenge 1/1
Follow up
Better after relocation
4/18/2008

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