Occupational Asthma Reference

Piirila P, Kanerva L, Keskinen H, Estlander T, Hytonen M, Tuppurainen M, Nordman H, Occupational respiratory hypersensitivity caused by preparations containing acrylates in dental personnel, Clin Exp Allergy, 1998;28:1404-1411,

Keywords: Finland, acrylate, dermatitis, occupational asthma, rhinitis, laryngitis, pharyngitis, PEF, dentist, nurse, conjunctivitis, challenge, methacrylate, epoxy, IgE

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Henrik Nordman, Finnsh Institute of Occupational Health Henrik Nordman

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BACKGROUND: Allergic contact dermatitis caused by acrylate compounds is common in dental personnel; they also often complain of work-related respiratory or conjunctival symptoms.

OBJECTIVE: The aim of the present study was to report the cases of acrylates induced respiratory hypersensitivity in dental personnel diagnosed in Finland during the last 6 years.

METHODS: Occupational asthma, rhinitis, laryngitis and pharyngitis cases were diagnosed according to patient history, PEF monitoring, and a work-simulating provocation test.

RESULTS: Twelve cases of respiratory hypersensitivity caused by acrylates diagnosed in dental personnel (six dentists and six dental nurses) in 1992-97 are reported. During this period one case of conjunctivitis and one of laryngitis have been published separately. Nine cases of occupational asthma, two rhinitis cases, and one laryngitis case were verified according to the challenge tests with dental acrylate compounds (acrylates, methacrylates and epoxy acrylates). Only three patients had positive skin-prick test reactions to common environmental allergens, and none reacted to acrylates in the skin-prick tests. Five patients had an elevated total IgE (>110 kU/L). PEF follow-up showed an occupational effect in all examined eight patients with diagnosed asthma. The mean duration of exposure to acrylates was 22 years, and the duration of respiratory symptoms 8 years.

CONCLUSIONS: The results indicate that acrylates constitute an important hazard for dental workers. The mechanism of respiratory hypersensitivity is still unknown, and it is probably not IgE-mediated

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