Uronium peptide coupling agents: Another case of occupational airborne allergic sensitization induced by HBTU.

Uronium peptide coupling agents (HBTU, HATU, and HCTU) create a special hazard as they are immune sensitizers. Few reported cases are mentioned in the literature; despite that, it is important to raise the awareness on the subject and to highlight the risk and potential symptoms that could occur to those who directly work in contact with uronium peptide coupling agents, as well as to the safety deputies in the universities and industries. Based on a personal experience, the health impact of laboratory exposure to HBTU is described, and the insights gained from the experience are developed. A skin irritation reaction and allergy symptoms induced by HBTU exposure are shown here as well as the rate of worsening of symptoms since the first allergic reaction. Recommendations for handling coupling agents more safely in the research laboratory will also be given, and a casuistry of the matter to help other lab-users to recognize, assess, minimize, prepare for emergencies (RAMP) process.