A Case of Occupational Asthma Induced by Falcata Wood ( Albizia falcataria )

Case: 72-yr-old manChief complaint: Breathing difficulty with wheezingwhen cutting Falcata.Personal medical history: Eczema since infancy.Tubercular pleurisy at the age of 28.Family medical history: Nothing of special note.Occupational history: Worker in wood furnitureproduction. Had been working with wood sincegraduation from junior high school.Working inpresent position since the age of 18.Smoking status: Nonsmoker, both present and past.Alcohol consumption: One bottle of beer and twoglasses of brandy every day.Pets: None.History of present illness: The patient had bronchialasthma at the age of 17. The main symptom was coughingwith slight breathing difficulty. At 30 yr of age, he wasstruck by a severe asthma attack, and was unconsciousovernight. From that time, his asthma attacks appearedonly at the turn of the season. Control by drug therapywas excellent for about ten years from when he was 60yr old, and there were no asthma attacks. The patientbecame conscious of breathing difficulty with wheezingafter entering the factory at the age of 70 yr. He began toregularly visit a local doctor’s office once a week. Hedid not have the complaint of itchy eyes. Theophyllinetablets were prescribed three times a day after each meal.Becromesazon inhalation medicine and Predonizorontablets were prescribed for use during an attack. Recently,he noticed that the symptoms appeared when cuttingFalcata with a circular saw. He could not enter the factorywhen Falcata was being cut. His symptoms appearedeven if he entered the factory without knowing thatFalcata had been cut. The severity of his symptomsgradually decreased when he left the factory and did notappear with wood other than Falcata. His symptomsdisappeared after the processing of Falcata wasdiscontinued.Two other employees also complained of sneezing,runny nose and voice change after cutting Falcata.However, they did not suffer from breathing difficultywith wheezing. Employees at other factories have alsocomplained of sneezing and runny nose after handlingFalcata.To confirm the diagnosis of occupational asthma (OA)induced by Falcata, the patient was hospitalized at theOsaka Prefectural Medical Center for Respiratory andAllergic Diseases on September 12, 2005. Signedinformed consent was obtained from the patient for thisstudy and the bronchial provocation test. This study andthe bronchial provocation test were approved by theHospital Ethics Committee. Findings on admission: Height 160.8 cm, weight 60Kg, temperature 36.5 °C, pulse 76 beats per minute, bloodpressure 140/75 mmHg, SpO