title: Asthma and allergy associated with occupational exposure to ispaghula and senna products in a pharmaceutical work force.
abstract: A cross-sectional study of 125 pharmaceutical workers engaged in the manufacture of bulk laxatives based on ispaghula husks (psyllium) and senna pods was conducted. Skin prick tests with extracts of these components revealed that 7.6% were allergic to ispaghula and 15.3% were allergic to senna. Four (3.2%) cases of occupational asthma were identified. The overall prevalence of asthma (6.4%) was less than in a comparable nonexposed Australian population (odds ration, 0.44). Symptoms referrable to the upper airways, eyes, and skin were more prevalent (52.0%) than in the reference population (odds ratio, 1.53). Smokers and nonatopic subjects were more likely to complain of these symptoms if they were sensitized to senna and/or ispaghula than if they were not sensitized (relative risks, 1.9 and 2.6, respectively). Sensitization to ispaghula and/or senna was not a risk factor for asthma. An IgE-mediated allergic mechanism is probably responsible for the allergic symptoms in many of these subjects. Smoking seems to be a cofactor in this process.
authors.affiliation: Institute of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
authors.forename: G B
authors.initials: GB
authors.lastname: Marks
authors.forename: C M
authors.initials: CM
authors.lastname: Salome
authors.forename: A J
authors.initials: AJ
authors.lastname: Woolcock
mesh_terms: D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004345:Drug Industry / Q000706:statistics & numerical data; D006801:Humans; D009517:New South Wales / Q000453:epidemiology; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D015995:Prevalence; D011620:Psyllium / Q000009:adverse effects*; D012129:Respiratory Function Tests; D012130:Respiratory Hypersensitivity / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D012135:Respiratory Sounds / Q000209:etiology; D012307:Risk Factors; D012676:Senna Extract / Q000009:adverse effects*; D012882:Skin Tests; D011795:Surveys and Questionnaires
chemical_list: D012676:Senna Extract; D011620:Psyllium