Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1988 May;43(5):371–377. doi: 10.1136/thx.43.5.371

Occupational asthma in workers of a pharmaceutical company processing spiramycin.

J L Malo 1, A Cartier 1
PMCID: PMC461250  PMID: 3194865

Abstract

After investigation of one worker with occupational asthma, all 51 employees of a pharmaceutical company processing the macrolide antibiotic spiramycin were investigated to determine the frequency of the condition and the risk factors. The antibiotic was produced for short periods four to five times a year. The first part of the investigation, conducted before a production period, consisted of the following: questionnaire, skinprick tests, blood sample, spirometry, assessment of bronchial responsiveness to methacholine, and monitoring of peak expiratory flow rates (PEF). The second part of the survey was carried out in 48 of the 51 workers during the production period, and included the same assessments except for skin testing. No FEV1 values had changed by more than 9% or PEF by more than 19%. Inhalation challenge with spiramycin was performed in 12 of the 14 individuals who had a history of occupational asthma, a provocative concentration of methacholine (PC20) of 16 mg/ml or less, or a PC20 that fell by 2.5 fold or more during the production period (or a combination of these). Three subjects experienced immediate bronchoconstriction. All reported symptoms, and all had a fall in PC20 methacholine during the production period. It is concluded that the minimum frequency of occupational asthma in this company processing spiramycin is 4/51 (7.8%). The combination of a positive response to the questionnaire and a change in bronchial hyperresponsiveness during the production period appeared to be the best detector of individuals with occupational asthma, as confirmed by inhalation challenge with spiramycin.

Full text

PDF
371

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Banks D. E., Barkman H. W., Jr, Butcher B. T., Hammad Y. Y., Rando R. J., Glindmeyer H. W., 3rd, Jones R. N., Weill H. Absence of hyperresponsiveness to methacholine in a worker with methylene diphenyl diisocyanate (MDI)-induced asthma. Chest. 1986 Mar;89(3):389–393. doi: 10.1378/chest.89.3.389. [DOI] [PubMed] [Google Scholar]
  2. Burge P. S. Occupational asthma in electronics workers caused by colophony fumes: follow-up of affected workers. Thorax. 1982 May;37(5):348–353. doi: 10.1136/thx.37.5.348. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cartier A., L'Archevêque J., Malo J. L. Exposure to a sensitizing occupational agent can cause a long-lasting increase in bronchial responsiveness to histamine in the absence of significant changes in airway caliber. J Allergy Clin Immunol. 1986 Dec;78(6):1185–1189. doi: 10.1016/0091-6749(86)90270-8. [DOI] [PubMed] [Google Scholar]
  4. Chan-Yeung M., Lam S., Koener S. Clinical features and natural history of occupational asthma due to western red cedar (Thuja plicata). Am J Med. 1982 Mar;72(3):411–415. doi: 10.1016/0002-9343(82)90497-1. [DOI] [PubMed] [Google Scholar]
  5. Chan-Yeung M., Lam S. Occupational asthma. Am Rev Respir Dis. 1986 Apr;133(4):686–703. doi: 10.1164/arrd.1986.133.4.686. [DOI] [PubMed] [Google Scholar]
  6. Cockcroft D. W., Killian D. N., Mellon J. J., Hargreave F. E. Bronchial reactivity to inhaled histamine: a method and clinical survey. Clin Allergy. 1977 May;7(3):235–243. doi: 10.1111/j.1365-2222.1977.tb01448.x. [DOI] [PubMed] [Google Scholar]
  7. Davies R. J., Pepys J. Asthma due to inhaled chemical agents--the macrolide antibiotic Spiramycin. Clin Allergy. 1975 Mar;5(1):99–107. doi: 10.1111/j.1365-2222.1975.tb01841.x. [DOI] [PubMed] [Google Scholar]
  8. Dehaut P., Rachiele A., Martin R. R., Malo J. L. Histamine dose-response curves in asthma: reproducibility and sensitivity of different indices to assess response. Thorax. 1983 Jul;38(7):516–522. doi: 10.1136/thx.38.7.516. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Hargreave F. E., Ramsdale E. H., Pugsley S. O. Occupational asthma without bronchial hyperresponsiveness. Am Rev Respir Dis. 1984 Sep;130(3):513–515. doi: 10.1164/arrd.1984.130.3.513. [DOI] [PubMed] [Google Scholar]
  10. Hetzel M. R., Clark T. J. Comparison of normal and asthmatic circadian rhythms in peak expiratory flow rate. Thorax. 1980 Oct;35(10):732–738. doi: 10.1136/thx.35.10.732. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hudson P., Cartier A., Pineau L., Lafrance M., St-Aubin J. J., Dubois J. Y., Malo J. L. Follow-up of occupational asthma caused by crab and various agents. J Allergy Clin Immunol. 1985 Nov;76(5):682–688. doi: 10.1016/0091-6749(85)90671-2. [DOI] [PubMed] [Google Scholar]
  12. Knudson R. J., Lebowitz M. D., Holberg C. J., Burrows B. Changes in the normal maximal expiratory flow-volume curve with growth and aging. Am Rev Respir Dis. 1983 Jun;127(6):725–734. doi: 10.1164/arrd.1983.127.6.725. [DOI] [PubMed] [Google Scholar]
  13. Mapp C. E., Dal Vecchio L., Boschetto P., De Marzo N., Fabbri L. M. Toluene diisocyanate-induced asthma without airway hyperresponsiveness. Eur J Respir Dis. 1986 Feb;68(2):89–95. [PubMed] [Google Scholar]
  14. Moscato G., Naldi L., Candura F. Bronchial asthma due to spiramycin and adipic acid. Clin Allergy. 1984 Jul;14(4):355–361. doi: 10.1111/j.1365-2222.1984.tb02216.x. [DOI] [PubMed] [Google Scholar]
  15. Paggiaro P. L., Loi A. M., Rossi O., Ferrante B., Pardi F., Roselli M. G., Baschieri L. Follow-up study of patients with respiratory disease due to toluene diisocyanate (TDI). Clin Allergy. 1984 Sep;14(5):463–469. doi: 10.1111/j.1365-2222.1984.tb02230.x. [DOI] [PubMed] [Google Scholar]
  16. Paggiaro P. L., Loi A. M., Toma G. Bronchial asthma and dermatitis due to spiramycin in a chick breeder. Clin Allergy. 1979 Nov;9(6):571–574. doi: 10.1111/j.1365-2222.1979.tb00481.x. [DOI] [PubMed] [Google Scholar]
  17. Pepys J., Hutchcroft B. J. Bronchial provocation tests in etiologic diagnosis and analysis of asthma. Am Rev Respir Dis. 1975 Dec;112(6):829–859. doi: 10.1164/arrd.1975.112.6.829. [DOI] [PubMed] [Google Scholar]
  18. Zammit-Tabona M., Sherkin M., Kijek K., Chan H., Chan-Yeung M. Asthma caused by diphenylmethane diisocyanate in foundry workers. Clinical, bronchial provocation, and immunologic studies. Am Rev Respir Dis. 1983 Aug;128(2):226–230. doi: 10.1164/arrd.1983.128.2.226. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES