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Occupational asthma from sensitization to a chlorine-containing triclosan cleaner
PDPI Surakarta, 24 Mei 2017 14:19:08
Occupational asthma from sensitization to a chlorine-containing triclosan cleaner




Gareth Walters1, Alastair Robertson1, Vicky Moore1 and Sherwood Burge1
1Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham, West Midlands, United Kingdom


We present evidence for respiratory sensitization to the chlorine-releasing antimicrobial compound triclosan, in a nursery nurse with occupational asthma. A 26-year old female was referred to the occupational lung disease clinic with a 7-month history of asthma symptoms progressively worse throughout the working week and better on days away from work. She required treatment with a combination corticosteroid and long-acting beta agonist inhaler. She had experienced previous childhood asthma, mild hay fever and an allergy to peanuts and hazelnuts. Her job required her to care for 30 infants and also to mop the floor daily using trisodium nitrilo-triacetate cleaner (Versatile) and clean tables while wearing nitrile gloves using triclosan-containing cleaner (Antibac). Serial peak flow readings showed evidence of occupational asthma (OASYS score=3.5) and spirometry was normal in clinic (FEV1=3.55L /103%; FVC=4.05/103%) while exposed at work. She underwent specific inhalational challenge to 70% alcohol gel (normal), Versatile cleaner (immediate irritant reaction) and to Antibac cleaner by painting on to cardboard for 30-38 minutes. Antibac caused an immediate asthmatic reaction with a maximum fall from baseline FEV1 (3.48L) of 24%. Non-specific bronchial reactivity and FENO remained normal throughout the challenge. The worker was partially relocated, and Antibac was substituted for an alternative cleaning agent. There is evidence from epidemiological study that triclosan exposure is associated with allergic sensitization to personal care products and cleaners (Bertelsen et al. Allergy 2013;68:84-91); however this is the first reported case of respiratory sensitization to a triclosan-containing cleaner.

http://erj.ersjournals.com/content/44/Suppl_58/P4541

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