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Occupational Asthma in Antibiotic Manufacturing Workers: Case Reports and Systematic Review

By Sara Díaz Angulo, Joanna Szram, Jenny Welch, Julie Cannon and Paul Cullinan


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

Topics: Review Article
Publisher: Hindawi Publishing Corporation
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Provided by: PubMed Central

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  1. (2006). a h m ,a n dH .S . Park, “Three cases of occupational asthma induced by thiamphenicol: detection of serum-specific
  2. (2005). a r v i s ,M .J .S e e d ,R .A .E l t o n ,L .S a w y e r ,a n dR .M . Agius, “Relationship between chemical structure and the occupational asthma hazard of low molecular weight organic compounds,”
  3. (1953). A.E.Roberts,“Occupationalallergicreactionsamongworkers in a penicillin manufacturing plant; simple and inexpensive method of diagnosis and treatment,”
  4. (1980). Acover Sanchez et al., “Asma por inhalaci´ on por penicilina ambiental,”
  5. (1979). Aspects of environmental health and of pathology caused by pollution with amoxicillin in a pharmaceutical industry,”
  6. (1957). Asthma caused by penicillin,”
  7. (1975). Asthma due to inhaled chemical agents: the macrolide antibiotic spiramycin,”
  8. (1997). Asthma to latex and amoxicillin,”
  9. (1999). Bomb´ ın, andA.Umpierrez,“Occupationalasthmainducedbycephalosporins,”
  10. (1979). Bronchial asthma and dermatitis due to spiramycin in a chick breeder,”
  11. (1981). Bronchial asthma caused byJournal of Allergy 9 7-aminocephalosporanic acid in workers engaged in the production of cephalosporins,”
  12. (1984). Bronchial asthma due to spiramycin and adipic acid,”
  13. (1981). C o u t t s ,M .B .D a l l y ,a n dA .J .N .T a y l o r ,“ A s t h m ai n workers manufacturing cephalosporins,”
  14. (1974). D a v i e s ,D .J .H e n d r i c k ,a n dJ .P e p y s ,“ A s t h m ad u et o inhaledchemicalagents:ampicillin,benzylpenicillin,6amino penicillanic acid and related substances,”
  15. (2003). Diagnosis of immediate allergic reactions to beta-lactam antibiotics,”
  16. (2009). Further validation of computerbased prediction of chemical asthma hazard,”
  17. (1977). Health aspects of antibiotic manufacture with particular emphasis on respiratory and genital disturbances (author’s translation),”
  18. (2003). Heterogeneity of IgE response to cefteram pivoxil was noted in 2 patients with cefteram-induced occupational asthma,”
  19. (1973). K a m m e r m e y e ra n dK .P .M a t h e w s ,“ H y p e r s e n s i t i v i t yt o phenylglycine acid chloride,”
  20. (1983). Methods for assessing bronchial reactivity,”
  21. Occupation-related bronchial asthma caused by ampicillin. Diagnostic significance of occupation-specific inhalation provocation tests,”
  22. (2009). Occupational asthma and rhinitis induced by a cephalosporin intermediate product: description of a case,”
  23. (1960). Occupational asthma caused by allergy to penicillin,”
  24. (1996). Occupational asthma caused by cefmetazole and 7-aminocephalosporanic acid: description of a clinical case,”
  25. (1995). Occupational asthma due to ceftazidime,”
  26. (2010). Occupational asthma due to colistin in a pharmaceutical worker,”
  27. (1988). Occupational asthma in workers of a pharmaceutical company processing spiramycin,”
  28. (1998). Occupational asthma specific to amoxicillin,” Allergy,
  29. (1995). Occupational asthma, rhinitis and urticaria due to piperacillin sodium in a pharmaceutical worker,”
  30. (2006). Other chemical substances causing occupational asthma,” in Asthma in the Workplace,
  31. (2004). P a r k ,K .U .K i m ,Y .M .L e ee ta l . ,“ O c c u p a t i o n a la s t h m a and IgE sensitization to 7-aminocephalosporanic acid,”
  32. (1997). Physician based surveillance system for occupational respiratory diseases: the experience of PROPULSE,
  33. (2009). r k , “A case of occupational asthma caused by inhalation of vancomycin powder,”
  34. (1976). Rischi lavorativiti da antibiotici: contributo allo studio della patologia professionale da spiramicina,”
  35. (1979). Some experiments on the allergic reaction among workers in a pharmaceutical factory (author’s translation),”
  36. (1977). Tetracycline asthma: a case report,”