Occupational asthma due to acrylates in a graphic arts worker.
BACKGROUND
Acrylates are used in a wide variety of products such as solvents, adhesives, paints, printing ink, soft contact lenses, porcelain nails, and methacrylates (used by dentists and orthopedists). Currently there are various types of acrylic compounds: acrylates, cyanoacrylates (such as tissue adhesives and home glues), and methacrylates (prostheses and dental and orthopedic fillings). The sensitization mechanism is unknown, but the allergy is believed to be due to a non-IgE mediated phenomenon, since a late asthmatic response occurs. Various cases of acrylate-induced asthma have been reported, especially in dentists and persons using glues or paints containing this substance.


METHODS
We present the case of a 52-year-old man who had been working in graphic arts for the previous 7 years. For the previous 2 years he had experienced persistent cough with a sensation of drowning, dyspnea that increased with moderate exertion, and nasal obstruction despite continuous treatment. The symptoms first appeared after an episode of acute respiratory difficulty associated with weight loss, pulmonary infiltrates, and eosinophilia. Peak expiratory flow (PEF) was measured during work and sick leave, and specific bronchial challenge with acrylates was performed in a bronchial chamber.


RESULTS
The PEF improved on weekends and sick leave. The challenge test provoked a late asthmatic response and the non-specific bronchial hyperreactivity increased after the test. As well in the sputum samples there was a increase of eosinophil amount.
Reig Rincón de Arellano
I
I
Allergy Service, Hospital Clínico San Carlos, Madrid, Spain. irrda@hotmail.com
Cimarra Alvarez-Lovell
M
M
Robledo Echarren
T
T
Fernández-Nieto
M
M
Quirce Gancedo
S
S
Seaone Plata
C
C
Martínez-Cócera
C
C
D000179:Acrylates / Q000009:adverse effects* / Q000032:analysis; D001154:Art; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis / Q000000981:diagnostic imaging; D001985:Bronchial Provocation Tests; D003371:Cough / Q000209:etiology; D047150:Eosinophil Cationic Protein / Q000032:analysis; D004802:Eosinophilia / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000276:immunology; D010150:Paint / Q000009:adverse effects*; D010366:Peak Expiratory Flow Rate; D011014:Pneumonia / Q000139:chemically induced; D011859:Radiography; D012882:Skin Tests; D013183:Sputum / Q000737:chemistry / Q000166:cytology
D000179:Acrylates; D047150:Eosinophil Cationic Protein