The spectrum of allergic disease in the chemical industry

Abstract

Objectives. To describe the types of allergic responses which can be seen among employees working in the chemical industry.

Methods. This is a review of current literature.

Results. Although allergic reactions are more frequently attributed to protein exposure, there is increasing evidence that certain chemicals can produce allergic disease for each of the four types of allergic reactions described by Gell and Coombs. Type I hypersensitivity reactions are seen with certain low-molecular-weight chemicals. Type II hypersensitivity reactions, exemplified by Goodpasture's syndrome, have been associated with certain metal exposures. Low-molecular-weight chemicals have been reported to cause type III hypersensitivity reactions such as those seen in hypersensitivity pneumonitis. Finally, the majority of type IV reactions are characterized by allergic contact dermatitis, although some hard metals have produced type IV pulmonary disease. Several predictive tests are now available to screen chemicals for pulmonary and skin sensitizing capability.

Conclusions. Chemicals have been implicated in producing a wide variety of hypersensitivity reactions. Screening tests can be of use in managing the risks of these chemicals.