Proteolytic enzyme sensitivity and decrease in respiratory function (a 10-year follow-up).
OBJECTIVE
In workers, sensitivity and occupational asthma are known to develop in reaction to the proteolytic enzymes used in the manufacture of detergents. This study was conducted to find out how this sensitivity to the proteolytic enzymes affects respiratory function, excluding occupational asthma.


METHODS
Workers in the detergent industry ( n = 65) were divided into four groups according to their prick-test results, as follows: those positive for at least one enzyme (Lipolase, Savinase) (group I, n = 15); enzyme-negative cases (group II, n = 50); and from among these, enzyme-positive non-smoking cases (group Ia, n = 11); enzyme-negative non-smoking cases (group IIa, n = 32). Respiratory function tests for the last 10 years from the archives were assessed. For statistic analysis, average values were determined and the standard deviation calculated. For comparison of the groups, the Mann-Whitney U and Fischer Exact chi-square tests were used.


RESULTS
The ratio of smokers, the cigarette burden, average age and the period of work were found to be similar between workers of groups I and II, and group Ia and group IIa ( P > 0.05). The average annual fall in the forced vital capacity (FVC) and the forced expiratory volume in the first second (FEV(1)) for the 10-year period was, respectively, found to be: group I, 64.1 +/- 7.8 ml and 58.7 +/- 9.6 ml; group II, 38.7 +/- 6.4 ml and 43.7 +/- 8.2 ml; group Ia, 60.7 +/- 8.1 ml and 56.1 +/- 10.2 ml; group IIa, 37.4 +/- 6.8 ml and 42.9 +/- 8.1 ml. The decrease in FVC and FEV(1) in group I compared with group II, and in group Ia compared with group IIa was statistically significant ( P < 0.001).


CONCLUSIONS
In this study, the observation that the FVC and FEV(1) of the workers were much lower than expected, especially among those sensitive to the enzymes, independently of occupational asthma and cigarette smoking, led to the conclusion that it could be due to sensitivity to the enzymes.
Kizkin
Ozkan
O
Department of Pulmonary Diseases, Turgut Ozal Medical Center, Inonu University, Malatya, Turkey. okizkin@inonu.edu.tr
Suleyman
Gamze Turker
GT
Hacievliyagil
S
S
Gunen
Hakan
H
D000328:Adult; D000485:Allergens; D001249:Asthma / Q000139:chemically induced* / Q000503:physiopathology; D003902:Detergents / Q000009:adverse effects / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007221:Industry; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D010447:Peptide Hydrolases / Q000009:adverse effects*; D012129:Respiratory Function Tests; D014421:Turkey
D000485:Allergens; D003902:Detergents; D010447:Peptide Hydrolases