Occupational Asthma Reference
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Angulo SD, Szram J, Welch J, Cannon J, and Cullinan P,
Occupational Asthma in Antibiotic Manufacturing Workers: Case Reports and Systematic Review,
J Allergy,
2011;ID 365683:9 pages,
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Keywords: review, antibiotic, occupational asthma, erythromycin, IgE, nc, ch, SIC, NSBR,
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Abstract
Background.
The risks of occupational asthma (OA) from antibiotics are uncertain. We report 4 new cases and a systematic review of the literature.
Methods.
Cases were identified through a specialist clinic, each underwent specific provocation testing (SPT). We subsequently reviewed the published literature.
Results.
The patients were employed in the manufacture of antibiotics; penicillins were implicated in three cases, in the fourth erythromycin, not previously reported to cause OA. In two, there was evidence of specific IgE sensitisation. At SPT each developed a late asthmatic reaction and increased bronchial hyperresponsiveness.
36 case reports have been previously published, 26 (citing penicillins or cephalosporins). Seven cross-sectional workplace-based surveys found prevalences of 5–8%.
Conclusions.
OA in antibiotic manufacturers may be more common than is generally recognised. Its pathogenesis remains unclear; immunological tests are of uncertain value and potential cases require confirmation with SPT. Further study of its frequency, mechanisms, and diagnosis is required.
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