Occupational asthma due to liquorice roots
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".