Purohit A, Kopferschmitt-Kubler M C, Moreau C, Popin E, Blaumeiser M, Pauli G
Service de Pneumologie, Hôpital Lyautey, Hôpitaux Universitaires de Strasbourg, France.
Int Arch Occup Environ Health. 2000 Aug;73(6):423-7. doi: 10.1007/s004200000162.
Quaternary ammonium compounds, among which benzalkonium chloride is one of the best-known, are commonly used as antiseptics, disinfectants, detergents and preservatives. They can cause occupational asthma, which however, has been rarely reported so far, despite wide use of these products. We report three such cases. Possible mechanisms causing asthma are discussed, taking into account their characteristics.
Our patients, all female nurses, manifested asthma symptoms upon handling disinfectant solutions containing benzalkonium chloride. Work-related fall in PEFR was observed in all of them. The diagnosis was confirmed by challenge tests where the patients were exposed, in a closed chamber, to suspected disinfectant contained in a tray. All of the women developed early or delayed symptoms upon exposure. Similar challenge tests to placebo or other disinfectants devoid of quaternary ammonium compound were negative.
These three cases, in addition to others reported in the literature, point out an as yet poorly known etiology of occupational asthma to quaternary ammonium compounds in hospital employees. The exact mechanism of the action remains unexplained.
季铵化合物是常用的防腐剂、消毒剂、洗涤剂和防腐剂，其中苯扎氯铵是最知名的一种。它们可引起职业性哮喘，然而，尽管这些产品广泛使用，但迄今为止很少有相关报道。我们报告三例此类病例，并根据其特点讨论了引发哮喘的可能机制。
我们的患者均为女性护士，在处理含苯扎氯铵的消毒溶液时出现哮喘症状。她们所有人均观察到与工作相关的呼气峰流速下降。通过激发试验确诊，试验中患者在密闭舱室内接触置于托盘中的可疑消毒剂。所有女性在接触后均出现早期或延迟症状。对安慰剂或不含季铵化合物的其他消毒剂进行的类似激发试验结果为阴性。
除文献中报道的其他病例外，这三例病例指出医院工作人员中职业性哮喘由季铵化合物引起这一迄今鲜为人知的病因。其确切作用机制尚不清楚。
