open access

Vol 62, No 3 (2010)
Case report
Submitted: 2013-02-18
Published online: 2010-12-06
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A case of occupational asthma from metabisulphite in a fisherman

Richard Pougnet, Brice Lodde, David Lucas, Dominique Jegaden, Sally Bell, Jean-Dominique Dewitte
International Maritime Health 2010;62(3):180-184.

open access

Vol 62, No 3 (2010)
MARITIME MEDICINE Case report
Submitted: 2013-02-18
Published online: 2010-12-06

Abstract


Background. The objective was to describe a case of occupational asthma in a fisherman linked to the inhalation of metabisulphites, then to discuss the history and actions for prevention.
Material and methods. We report the case of a fisherman fishing for Dublin bay prawn (Nephrops), who suffered from asthma after being exposed to metabisulphites. This case is compared with other cases in the occupational medical literature. He was a 53-year-old male and a former smoker, who presented with dyspnoea and a very productive cough, due to both chronic exposure to metabisulphites and acute exposure to contamination due to the breakdown of the ventilation system in the trawler on which he was fishing. The symptoms appeared to be occupational. Tests carried out in the following months revealed reversible airway obstruction with non-specific bronchial hyperreactivity, while allergy tests were negative. A visit to the trawler allowed us to determine the unusual cause of exposure in the case. Other reported cases concern normal working processes causing reversible airway obstruction.
Discussion. Metabisulphites are antioxidants and preservatives used in the food industry which have been identified as the causative agent in occupational asthma since the 1980s. Only two other cases have been previously reported in fishermen, however. The clinical presentation of our subject was notable for the productive nature of his cough. The appearance of symptoms after combined acute and chronic exposure made us consider an irritative pathophysiology in this asthma, as opposed to sensitization. The negative allergy testing in this subject was similar to other cases reported in the literature. Our subject alone was submitted to patch testing, which was also negative.
Conclusions. Our case represents occupational asthma caused by metabisulphites with clinical signs notable for the productive nature of the cough. Few cases have been reported amongst fishermen despite the significant use of this substance with irritant and sensitizing characteristics in the workplace.

Abstract


Background. The objective was to describe a case of occupational asthma in a fisherman linked to the inhalation of metabisulphites, then to discuss the history and actions for prevention.
Material and methods. We report the case of a fisherman fishing for Dublin bay prawn (Nephrops), who suffered from asthma after being exposed to metabisulphites. This case is compared with other cases in the occupational medical literature. He was a 53-year-old male and a former smoker, who presented with dyspnoea and a very productive cough, due to both chronic exposure to metabisulphites and acute exposure to contamination due to the breakdown of the ventilation system in the trawler on which he was fishing. The symptoms appeared to be occupational. Tests carried out in the following months revealed reversible airway obstruction with non-specific bronchial hyperreactivity, while allergy tests were negative. A visit to the trawler allowed us to determine the unusual cause of exposure in the case. Other reported cases concern normal working processes causing reversible airway obstruction.
Discussion. Metabisulphites are antioxidants and preservatives used in the food industry which have been identified as the causative agent in occupational asthma since the 1980s. Only two other cases have been previously reported in fishermen, however. The clinical presentation of our subject was notable for the productive nature of his cough. The appearance of symptoms after combined acute and chronic exposure made us consider an irritative pathophysiology in this asthma, as opposed to sensitization. The negative allergy testing in this subject was similar to other cases reported in the literature. Our subject alone was submitted to patch testing, which was also negative.
Conclusions. Our case represents occupational asthma caused by metabisulphites with clinical signs notable for the productive nature of the cough. Few cases have been reported amongst fishermen despite the significant use of this substance with irritant and sensitizing characteristics in the workplace.
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Keywords

occupational diseases; asthma; sulphites

About this article
Title

A case of occupational asthma from metabisulphite in a fisherman

Journal

International Maritime Health

Issue

Vol 62, No 3 (2010)

Article type

Case report

Pages

180-184

Published online

2010-12-06

Bibliographic record

International Maritime Health 2010;62(3):180-184.

Keywords

occupational diseases
asthma
sulphites

Authors

Richard Pougnet
Brice Lodde
David Lucas
Dominique Jegaden
Sally Bell
Jean-Dominique Dewitte

References (15)
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