Advertisement

Occupational asthma due to tampico fiber bystander exposure in a brush production company—case report and literature review

  • Monika Raulf
  • Ingrid Sander
  • Thomas Brüning
  • Silke König
mini-review
  • 6 Downloads

Abstract

Background

A female machine operator in a brush factory presented for an expert medical examination due to suspected occupational obstructive pulmonary disease. She reported the occurrence of severe respiratory distress whenever colleagues in the same working area processed tampico fibers or a mixture of tampico fibers and bassine. The challenge posed in terms of the expert appraisal was to either prove or rule out occupational causality and IgE-mediated (IgE, immunglobulin E) sensitization in relation to the reported workplace-related symptoms.

Methods

As part of the further diagnostic work-up, tampico fibers were isolated from the workplace and the proteins biotinylated and coupled to a streptavidin ImmunoCAP for specific IgE testing. The material taken from the workplace was checked for mite allergen contamination. In addition, a systematic literature search was conducted in PubMed on “agave-/tampico fibers and diseases.”

Results

Tampico-specific IgE antibodies (10.5 kU/l and immunoblot labeling of protein bands in the 25-kDa range) were detected in the patient’s serum. The inhibition assay showed that mite-allergen contamination of the tampico materials was not responsible for the IgE reactivity.

Conclusion

Tampico fibers are robust fibers obtained from the leaves of the Mexican Agave lechugilla. The literature describes several cases of skin reactions in the form of irritant contact dermatitis due to occupational exposure to agave leaves or contact with agave sap. In the present case, the asthma symptoms of a female worker in a brush factory were attributed to inhalant bystander exposure to tampico fibers in the workplace. The unequivocal evidence of sensitization to tampico fibers met the medical requirements for the recognition of an occupational disease (BK 4301).

Keywords

Occupational allergy Tampico fiber IgE detection Occupational exposure Allergen identification 

Abbreviations

CCD

Cross-reactive carbohydrate determinant

ELISA

Enzyme-linked immunosorbent assay

FeNO

Fractional exhaled nitric oxide

ICS

Inhalant corticosteroid

IgE

Immunoglobulin E

kDa

Kilodalton

kU

Kilounit

LABA

Long-acting beta agonists

ppm

Parts per million

SABA

Short-acting beta agonists

SDS-PAGE

Sodium dodecyl sulfate polyacrylamide gel electrophoresis

sIgE

Specific immunoglobulin E

Notes

Conflict of interest

M. Raulf has received lecture fees from ThermoFisher Scientific, Astellas, and HAL. I. Sander, T. Brüning, and S. König declare that they have no competing interests.

References

  1. 1.
    Bradford MM. A rapid and sensitive method for the quantitation of microgram quantities of protein utilizing the principle of protein-dye binding. Anal Biochem. 1976;72:248–54.CrossRefGoogle Scholar
  2. 2.
    Sander I, Kespohl S, Merget R, Goldscheid N, Degens PO, Brüning T, et al. A new method to bind allergens for the measurement of specific IgE antibodies. Int Arch Allergy Immunol. 2005;136:39–44.CrossRefGoogle Scholar
  3. 3.
    Sander I, Zahradnik E, Kraus G, Mayer S, Neumann HD, Fleischer C, et al. Domestic mite antigens in floor and airborne dust at workplaces in comparison to living areas: a new immunoassay to assess personal airborne allergen exposure. PLoS ONE. 2012;7:e52981.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Crawford GH, Eickhorst KM, McGovern TW. Botanical briefs: the century plant—Agave Americana L. Cutis. 2003;72:188–90.PubMedGoogle Scholar
  5. 5.
    Brenner S, Landau M, Goldberg I. Contact dermatitis with systemic symptoms from Agave Americana. Dermatology. 1998;196:408–11.CrossRefPubMedGoogle Scholar
  6. 6.
    Ricks MR, Vogel PS, Elston DM, Hivnor C. Purpuric agave dermatitis. J Am Acad Dermatol. 1999;40:356–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Salinas ML, Ogura T, Soffchi L. Irritant contact dermatitis caused by needle-like calcium oxalate crystals, raphides, in Agave tequilana among workers in tequila distilleries and agave plantations. Contact Dermatitis. 2001;44:94–6.CrossRefPubMedGoogle Scholar
  8. 8.
    High WA. Agave contact dermatitis. Am J Contact Dermat. 2003;14:213–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Quirce S, Fernández-Nieto M, Pastor C, Sastre B, Sastre J. Occupational asthma due to tampico fiber from agave leaves. Arerugi. 2008;63:943–5.Google Scholar
  10. 10.
    Buhl R, Bals R, Baur X, Berdel D, Criée CP, Gappa M, et al. S2k-Leitlinie zur Diagnostik und Therapie von Patienten mit Asthma. 2017. https://www.awmf.org/uploads/tx_szleitlinien/020-009l_S2k_Asthma_Diagnostik_Therapie_2017-11_1.pdf.Google Scholar
  11. 11.
    Deutsche Gesetzliche Unfallversicherung (DGUV), editor. Reichenhaller Empfehlung. Empfehlung für die Begutachtung der Berufskrankheiten der Nummern 1315 (ohne Alveolitis), 4301 und 4302 der Anlage zur Berufskrankheiten-Verordnung (BKV). 2012. http://publikationen.dguv.de/dguv/pdf/10002/reichenhallneu.pdf.Google Scholar

Copyright information

© Springer Medizin Verlag GmbH, a part of Springer Nature 2018

Authors and Affiliations

  • Monika Raulf
    • 3
  • Ingrid Sander
    • 1
  • Thomas Brüning
    • 1
  • Silke König
    • 2
  1. 1.Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr-University Bochum (IPA)BochumGermany
  2. 2.Department of Occupational Lung and Respiratory DiseasesStatutory Accident Insurance Clinic FalkensteinFalkensteinGermany
  3. 3.Institute for Prevention and Occupational Medicine of the German Social Accident InsuranceInstitute of the Ruhr University Bochum (IPA)BochumGermany

Personalised recommendations