Diethanolamine-induced occupational asthma, a case report.
BACKGROUND
Amino alcohols are low molecular weight chemicals used widely in industrial processes, often as minor constituents. They have been found to cause allergic contact dermatitis. Marked exposure through airways is uncommon in other than occupational settings where chemicals containing amino alcohols may be heated or vaporized, liberating free amino alcohols into the ambient air. A few cases of asthma and allergic rhinitis have been reported, but the amounts inducing the airway reactions have not been defined.


OBJECTIVE
To further characterize ethanolamine-induced asthma and define the concentration inducing the asthmatic reaction, a case of diethanolamine-induced occupational asthma in a patient handling diethanolamine containing cutting fluid is reported.


METHODS
Suspicion of work related asthma was raised by symptoms and peak expiratory flow monitorings at work and at home. Specific bronchial provocation tests with the cutting fluid containing DEA and with DEA aerosol at two different concentration below the American Conference of Governmental Industrial Hygienists threshold limit value of DEA (2.0 mg/m3) were done.


RESULTS
DEA caused asthmatic airway obstruction at two different concentrations below the ACGIH TLV. A slight dose-response relationship was observed. Specific IgE-antibodies against DEA could not be found.


CONCLUSIONS
DEA is able to induce occupational asthma by a sensitization mechanism, the exact pathophysiological mechanism of which is not known.
Piipari
R
R
Finnish Institute of Occupational Health, Helsinki.
Tuppurainen
M
M
Tuomi
T
T
Mäntylä
L
L
Henriks-Eckerman
M L
ML
Keskinen
H
H
Nordman
H
H
D000328:Adult; D001249:Asthma / Q000139:chemically induced*; D001985:Bronchial Provocation Tests; D004983:Ethanolamines / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D008297:Male; D008669:Metallurgy; D009784:Occupational Diseases / Q000139:chemically induced*; D010366:Peak Expiratory Flow Rate
D004983:Ethanolamines; C020283:diethanolamine