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ACUTE BRONCHIOLITIS FOLLOWING PROVOCATIVE INHALATION OF “ALCALASE“—A PROTEOLYTIC ENZYME USED IN THE DETERGENT INDUSTRY
Author(s) -
Mitchell C. A.,
Gandevia Bryan
Publication year - 1971
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1971.tb50332.x
Subject(s) - bronchiolitis , inhalation , proteolytic enzymes , enzyme , medicine , asthma , chemistry , anesthesia , respiratory system , biochemistry
A pulmonary reaction characterized by the development of bilateral inspiratory and expiratory fine rales was observed in 11 of 29 subjects on brief exposure to aerosol “Alcalase”, a proteolytic enzyme used in detergent powders. The concentration of “Alcalase” producing the reaction varied from 0·01 to 10 mg/ml (tending to be lower in skin‐sensitized subjects), within the range likely to be encountered under the working conditions obtaining at the time. The pulmonary reaction occurred alone in four subjects. In the remaining seven subjects, it was associated with, although temporally independent of, an immediate or late bronchial reaction, as indicated by the development of asthmatic symptoms and a decrease in FEV 1 . Symptoms were absent or minimal in the absence of a bronchial reaction. Neither skin sensitivity nor symptoms on industrial exposure were related to the development of râles on challenge. The reaction, which presumably occurs in the bronchioles or small airways, raises the possibility of long‐term effects, 3 and raises special problems and obligations in medical surveillance during individual exposures and as a long‐term procedure.