Malo J L, Cartier A, Pineault L, Dugas M, Desjardins A
Dept of Chest Medicine, Höpital du Sacré-Coeur, Montreal, Canada.
Eur Respir J. 1994 Feb;7(2):415-7.
A 35 year-old nonatopic woman was referred to the hospital for possible work-related asthma. She had worked as an operator, at a plant producing polypropylene bags, for the previous four yrs. Her main complaint was a productive cough with dyspnoea and wheezing, as well as rhinitis over the past 3 yrs. She had been absent from work for 6 months on maternity leave, and had improved greatly. She was on a beta 2-adrenergic agent and had to take it at least four times daily. Baseline spirometry whilst at work showed marked airflow obstruction (forced expiratory volume in one second (FEV1) of 43% predicted (pred). After two months away from work FEV1 improved to 89% pred; provocative concentration of histamine causing a 25% fall in FEV1 (PC20) was 3.6 mg.ml-1 (mild airway hyperresponsiveness). Return to work resulted in a marked deterioration in FEV1, and serial peak expiratory flow (PEFR) values. PC20 was 0.11 mg.ml-1 (severe airway hyperresponsiveness) one week after she had returned to work. Specific inhalation challenges with polypropylene heated to 250 degrees C resulted in a late asthmatic reaction. As formaldehyde is one of the degradation products of heating polypropylene, we exposed her to it for up to 2 h, but we elicited no bronchospastic reaction. We conclude that heated polypropylene should be listed as one of the agents that causes occupational asthma.
一名35岁的非特应性女性因可能患有职业性哮喘被转诊至医院。在过去四年里，她一直在一家生产聚丙烯袋的工厂担任操作员。她的主要症状是咳痰、呼吸困难和喘息，以及在过去三年中出现的鼻炎。她休产假6个月未上班，症状有了很大改善。她正在使用β2肾上腺素能药物，并且每天至少服用四次。工作时的基础肺功能检查显示存在明显的气流阻塞（一秒用力呼气量（FEV1）为预测值（pred）的43%）。离开工作岗位两个月后，FEV1改善到预测值的89%；引起FEV1下降25%的组胺激发浓度（PC20）为3.6mg/ml（轻度气道高反应性）。重返工作岗位后，FEV1以及连续的呼气峰值流速（PEFR）值显著恶化。她重返工作岗位一周后，PC20为0.11mg/ml（严重气道高反应性）。对加热到250摄氏度的聚丙烯进行特异性吸入激发试验会引发迟发性哮喘反应。由于甲醛是加热聚丙烯的降解产物之一，我们让她接触甲醛长达2小时，但未引发支气管痉挛反应。我们得出结论，加热后的聚丙烯应被列为导致职业性哮喘的致病因素之一。
