Occupational Lung Disease Service, Birmingham Chest Clinic, 151 Great Charles Street, Birmingham B3 3HX, UK.
Occup Med (Lond). 2017 Jun 1;67(4):282-289. doi: 10.1093/occmed/kqx036.
Acrylic monomers (acrylates), methacrylates and cyanoacrylates all cause asthma by respiratory sensitization. Occupational inhalation exposures occur across a variety of industries including health care and dental work, beauty, laboratory science, assembly and plastic moulding.
To examine notifications of occupational asthma caused by acrylic compounds from a UK-based regional surveillance scheme, in order to highlight prevalent exposures and trends in presentation.
Retrospective review of all cases reported to the SHIELD surveillance scheme for occupational asthma, West Midlands, UK between 1989 and 2014. Patient data were gathered on demographics, employment, asthma symptoms and diagnostic investigations including serum immunological testing, serial peak flow analysis and specific inhalation challenge tests. Descriptive statistics were used to illustrate worker characteristics and evidence for sensitization to acrylic compounds.
There were 20 affected patients out of 1790 total cases of occupational asthma (1%); all cases were confirmed by OASYS (Occupational Asthma SYStem) analysis of serial peak flow measurements, with three additional positive specific inhalation challenge tests. Three out of 20 (15%) patients were current smokers and 11/20 (55%) were atopic. A variety of exposures and industries were implicated including: manufacturing, health care, beauty and printing and a novel presentation seen in teachers exposed to floor adhesives.
This is the largest reported series of occupational asthma caused by acrylic compounds, which remain an important aetiological factor in this disease. Exposure occurs in a variety of industries, particularly in manufacturing and is seen with other, perhaps better recognized sensitizing agents such as isocyanates and epoxy resins.
丙烯酰胺单体（丙烯酰胺）、甲基丙烯酰胺和氰基丙烯酰胺均通过呼吸道致敏引起哮喘。职业性吸入暴露发生在包括医疗保健和牙科工作、美容、实验室科学、装配和塑料成型在内的各种行业中。
检查英国基于区域监测计划的职业性哮喘由丙烯酸化合物引起的通知，以突出普遍的暴露和发病趋势。
对英国西米德兰兹郡 SHIELD 职业性哮喘监测计划 1989 年至 2014 年报告的所有病例进行回顾性审查。收集患者的人口统计学、就业、哮喘症状和诊断性检查的数据，包括血清免疫学检测、系列峰流速分析和特定吸入性挑战试验。使用描述性统计数据来说明工人特征和对丙烯酸化合物致敏的证据。
在 1790 例职业性哮喘总病例（1%）中，有 20 例受影响的患者；所有病例均通过 OASYS（职业性哮喘 SYStem）分析系列峰流速测量得到确认，另外还有 3 例阳性特定吸入性挑战试验。20 例患者中有 3 例（15%）为当前吸烟者，11/20 例（55%）为特应性。涉及多种暴露和行业，包括制造业、医疗保健、美容和印刷业，以及暴露于地板胶的教师中出现的新发病例。
这是迄今为止报道的由丙烯酸化合物引起的职业性哮喘最大系列，这些化合物仍然是这种疾病的一个重要病因。暴露发生在各种行业中，特别是在制造业，并且与其他可能更被认识的致敏剂如异氰酸酯和环氧树脂一起出现。
