Occupational asthma due to liquorice roots
Notice bibliographique
Résumé
We describe the case of an herbalist who developed occupational asthma due to liquorice roots as confirmed by specific inhalation challenges. Many high-molecular-weight agents have been reported as causes of occupational asthma (OA) (1) (asthmanet.com, asthme.csst.qc.ca) A 33-year-old woman started to work as an herbalist 13 years ago. In her workplace, she was exposed to several natural products. She started suffering from asthma 8–9 years before being referred. She reported that her asthma symptoms were worse at work and improved on weekends and during a maternity leave. She also had rhinoconjunctivitis symptoms at work. She mentioned that several products brought on asthmatic symptoms when she handled them in powder form at work, including liquorice root. Her FEV1 varied from 1.5 to 2.2 L (pred = 3.2 l) and the concentration of methacholine causing a 20% fall in FEV1 (PC20 values), from 0.5 to 2.0 mg/ml (slight to moderate airway hyperresponsiveness (2) when she was assessed while at work. Peak expiratory flows showed greater fluctuations in some instances during periods at work. Skin-prick tests with a liquorice extract showed an 8 mm immediate weal. Skin-prick tests were also positive (= 3 mm weal) to common inhalants (pollens, mites) and to other products handled at her workplace, including echinacea, nettle, hop and thistle. Specific inhalation challenges carried out by exposing the subject with a dry aerosol generator (3,4) to liquorice root powder at concentrations lower than 10 mg/m3 and for progressively increasing periods up to a total of 90 min induced a 25% immediate fall in FEV1 without significant late reaction (Fig. 1). PC20 did not change significantly in the afternoon of the challenge day to liquorice roots (PC20 at 1.3 mg/ml by comparison with a value of 2.0 mg/ml before exposure). The patient was removed from her workplace with improvement in her symptoms. Values of Fev1 as a function of time after exposure to lactose and liquorice roots. This case report shows that liquorice roots can cause OA through an apparently IgE-mediated mechanism as seen by immediate skin reactivity reaction to the diluted powder of liquorice root. Thesubject also presented symptoms of occupational rhinoconjunctivitis, which is commonly encountered in the case of high-molecular-weight agents (5). Herbalists are typically at risk of developing IgE-mediated allergic conditions (6), as they are exposed to several seeds, herbs and derivatives of vegetal products. Other vegetal roots can cause OA. Vandenplas and co-workers indeed described an interesting case of OA due to sarsaparilla root dust (7). The authors thank Lori Schubert for reviewing the manuscript.
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Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,002 |
Scores machine (provisoires)
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