Acute occupational exposure to holothurians (Cucumaria frondosa) resulting in irritating symptoms: About three cases.

Holothurians are marine invertebrates also known as sea cucumbers. They are used in fresh or dried forms in various cuisines around the world and have alleged medicinal properties. Consequently, sea cucumbers, notably the orange-footed sea cucumber (Cucumaria frondosa)are increasingly harvested from the environment or farmed via aquaculture. We report three cases of unusual occupational exposure to C. frondosa resulting in cutaneous, respiratory and ocular irritating symptoms. These symptoms occurred as sea cucumbers were cut on half and eviscerated manually, following a machine breakdown in a sea cucumber processing factory. Given the composition of holothurians, these symptoms probably resulted from the aerosolization of various holothurins, saponins secreted by sea cucumbers as mean of defense. Treatment was solely symptomatic and included decontamination of the skin and the eyes, inhaled glucocorticoids, anticholinergic agents and oral glucocorticoids. As the exposure resulted from a machine breakdown, no specific protective equipment was put in place. Employees were advised not to handle manuallythe sea cucumbers in case such a breakdown was to happen again.