Introduction
Methods
Occupational asthma due to allergens
Occupational asthma due to irritants
***
| Strong evidence – provided by generally consistent findings in multiple, high quality, scientific studies. |
** | Moderate evidence – provided by generally consistent findings in fewer, smaller or lower quality, scientific studies. |
*[*] | Moderate evidence – provided by generally consistent findings in fewer, smaller or lower quality, scientific studies, based on questionnaire-conducted studies or other weak evidence (i.e. clinical weakness due to absence of LFT, sPFT, SIC) |
* | Limited or contradictory evidence – provided by one scientific study (analytic) or inconsistent findings in multiple scientific studies. |
[*] | Limited or contradictory evidence – provided by one scientific study (analytic) or inconsistent findings in multiple scientific studies, based on questionnaires or other weak evidence ( i.e. clinical weakness due to absence of LFT, sPFT, SIC) |
(*) | Very limited or contradictory evidence – provided by at least three case reports, one case series, one non-analytic study or one occupational disease statistical study with at least five asthma cases |
- | No scientific evidence – based on clinical studies, theoretical considerations and/or clinical consensus |
Results
Overview(Table 2)
Findings | Allergens | Irritants |
---|---|---|
Potentially relevant publications and considered | 2,315 | 863 |
Publications which were found to be useful and were included | 865 | 474 |
Different potential causative agent or workplaces identified | 372 | 184 |
Evidence-based causative agents or workplaces* | 78 | 71 |
Strength of evidence per agent or worksite(Table 3)
Evidence level (modified RCGP three star grading) | Allergens /irritants: number of agents or worksites | Agent or worksite allergen | Agent or worksite irritant |
---|---|---|---|
[Synonym] (CAS) | |||
*** | 1/0 | Co-exposure to various lab animals | - |
** | 18/12 | Alpha-amylase from Aspergillus oryzae; various enzymes from Bacillus subtilis; papain; bakery (flour; amylase; storage mites); western red cedar; latex; Psyllium; farming (animals, cereal, hay, straw and storage mites); storage mites; rats; carmine; egg proteins; Atlantic salmon; fishmeal; Norway lobster; prawns; snow crabs; seafood; trout and turbot; reactive dyes; toluene diisocyanates (TDI); platinum salts; | Benzene-1,2,4-tricarboxylic acid; 1,2- anhydride [trimellitic anhydride] (552-30-7); chlorine (7782-50-5); cobalt (7440-48-4); various isocyanates, isocyanurate (HDI, MDI, TDI), phenylmethane diisocyanate [MDI] (5873-54-1), toluene diisocyanate, TDI 2,4 (584-84-9),TDI 2,6: (91-08-7); platinum salts (7440-06-4); cement [78]; environmental tobacco smoke; grain [78]; welding fumes; construction work (dust, agent unspecified); farming, animals (pig, beef/veal, dairy, poultry); swine confinement; World Trade Center disaster 2001 |
*[*] | 17/39 | Detergent enzymes, soybean (husks, flour); paprika; tea dust; tobacco; Aspergillus niger; cows; predatory mites; spider mites; opiates; methylene diphenyl diisocyanate (MDI), phthalic anhydrides; various isocyanates | Ceramic production [78]; phthalic anhydride (85-44-9); glutaraldehyde [glutaral] (11-30-8); sulfur dioxide (7446-09-5); cotton (dust; raw) CNT 750; potroom aluminum smelting; farming (various); foundry; smoke (fires, pyrolysis products); pesticides (unspecified); cleaning agents (unspecified); health care workers; |
* | 18/39 | Eastern white cedar; various flowers; guar gum; poppy; rose (Rosa rugosa); senna; ispaghula husks; sunflower pollen; trypsin; various woods (abies, chestnut, douglas, framire, mansonia, oak, obeche, walnut, white poplar); weeping fig; nonbiting midges; hexahydrophthalic anhydride; hexamethylene diisocyanate (HDI); methyl tetrahydrophthalic anhydride (MTHPA); persulfate salts; polyfunctional aziridine | Acetic acid (64-19-7); sulfuric acid (7664-93-9); metacrylates; loctide (53858-53-0); aluminum salts [aluminum fluoride] (7724-18-1); aluminum sulfate: (10043-01-3); ammonia (7664-41-7); various anhydrides; tetrachlorophthalic anhydride (117-08-8); azobisformamide (123-77-3); cadmium (fumes) (7440-43-9); carbon black dust (1333-86-4); ethylenediamine (107-15-3); formaldehyde (gas, dust) (50-00-0); hexamethylene-tetramine (100-97-0); methyl isocyanate [MIC] (624-83-9); naphthylene diisocyanate (3173-72-6); polymethylene polyphenyl isocyanate (9016-87-9); N-methylmorpholine (09-02-4); ozone (gassings) (10028-15-6); paraquat (4685-14-7); diammonium peroxodisulfate (7727-54-0); phenylglycine acid chloride (39478-47-2); piperazine dihydrochloride (142-64-3); polyvinyl chloride (fume) (9002-86-2); rosin core solder; thermal decomposition (8050-09-7); vanadium (7440-62-2) + divanadium pentoxide (1314-62-1); cleaning agents (not specified); green coffee [78]; diesel exhaust; endotoxin; oil (spill); paint (fumes); pesticides (unspecified); reactive dyes; refractory ceramic fibers [RCF]; smoke (fires, pyrolysis products; oil fire and dust storm); soldering flux; solvents (unspecified); healthcare workers; poultry confinement; slaughter house; metal industry workers |
[*] | 24/3 | Alternaria; bromelain from Ananas comosus; cellulase from Trichoderma viride; lactase from aspergillus; various enzymes; chrysanthemums; castor beans; madagascar jasmine; pine; flowers; budgerigar; flour moth; house dust mites; mouse; poultry; red soft corals; screw-worm fly; shrimp; various birds; cephalosporine; penicillins; phenylglycine; acid chloride; trimellitic anhydride | Nitrogen chloride (10025-85-1); polyamines; aliphatic; potassium persulfate (7727-21-1) and ammonium peroxydisulfate (7727-54-0); grain rice [78] |
(*) | 19/29 | Aspergillus enzymes; cellulase from Trichoderma reesei; pancreatin; proteolytic enzymes; asparagus; Boletus edulis; carnation; garlic dust; rye flour; gum arabic; iroko; various woods; African maple; black bat; mealworm; poultry mites; tetrachlorophtalic anhydride; chloramine T; chromium and nickel | Acids not specified; hydrochloric acids (7647-01-0); alkyl cyanoacrylates; 3-amino-5-mercapto-1;2,4-triazole l(16691-43-3); aziridine, polyfunctional [78] (64265-57-2); chloramine T (powder dust) (7080-50-4); chromate (not specified); 3-(diamino-amino)propylamine (109-55-7); dichlorodiethyl sulfide (505-60-2); 2-diethylaminoethanol (100-37-8); diinitrogen tetraoxide (10544-72-6); hexamethylene diisocyanate [HDI], plus isodurane diisocyanate (822-06-0); HDI biuret plus (4035-89-6); anhydrous nickel sulfate (7786-81-4); hexahydrate (10101-97-0); paraphenylenediamine (106-50-3); persulfate (not specified); polypropylene, heated to 250°C (9003-07-0); potassium dichromate (7778-50-9); potassium aluminum tetrafluoride (14484-69-6); sodium iso-nonanoyl oxybenzene sulfonate [SINOS] (123354-92-7); sodium metabisulfite (7681-57-4); styrene monomer (100-42-5); chlorofluorocarbons (degradation products); hairdressing chemicals; lubricants (unspecified); paper dust A111; aliphatic polyamines; polyester; powder paints; smoke (biomass, indoor) |
- | 275/94 | Unlisted as no corroborating scientific evidence presented | Unlisted as no corroborating scientific evidence presented |
Allergens
Irritants
Agents behaving as both allergen and irritant
Agent | Evidence level as allergen | Evidence level as irritant | H334 | H335 |
---|---|---|---|---|
Aluminium/potroom | - | * | ||
2-Ethanolamine
|
-
|
-
| x | |
Aminoethylethanolamine
|
-
|
-
| x | |
Anhydrides, various
|
-
|
*
| x | |
Anhydrides, hexahydrophthalic
|
*
|
-
| x | |
Anhydrides, maleic
|
-
|
-
| x | |
Anhydrides, methyltetrahydrophththalic
|
-
|
-
| x | |
Anhydrides, phthalic anhydride | *[*] | *[*] | x | x |
Anhydrides, tetrachlorophthalic anhydride | (*) | * | x | |
Azobisformamide | - | * | x | |
Captafol | - | - | ||
Chloramine T | (*) | (*) | x | |
Chlorohexidine | - | - | x | x |
Cobalt | - | ** | ||
Diethanolamine | - | - | ||
Formaldehyde | - | * | x | |
Glutaraldehyde | - | *[*] | x | |
Hexachlorphene | - | - | ||
Isocyanate, diphenylmethane diisocyanate (MDI) | *[*] | ** | x | x |
Isocyanate, hexamethylene diisocyanate (HDI) | * | (*) | x | x |
Isocyanate, 1,5-naphthylene diisocyanate (NDI) | - | (*) | x | x |
Isocyanate, toluene diisocyanate (TDI) | ** | ** | x | x |
Isocyanate, triglycidil isocyanurate | - | - | ||
Paraphenylenediamine | - | (*) | ||
Persulfate | * | (*) | x | x |
Piperazine dihydrochloride | - | * | x | |
Platinum salts | ** | ** | ||
Tetrachloroisophthalonitrile | - | - | x | |
Tributyl tin oxide | - | - | ||
Vanadium | - | * | ||
Zinc | - | - | ||
Green coffee (dust) | *[*] | * | ||
Reactive dye | ** | * | ||
Welding fumes | - | ** | ||
Farming | ** | *[*] | ||
Poultry confinement | [*] | *(*) |