Occupational sensitization to lupin in the workplace: occupational asthma, rhinitis, and work-aggravated asthma.
BACKGROUND
Lupin is a legume. Its seed can be ground into flour and incorporated into food as a protein source. Cases of rhinitis, urticaria, and anaphylaxis from ingestion of lupin have been reported as well as asthma.


OBJECTIVE
To present a cross-sectional study of workers in a food processing company who were exposed to lupin and developed occupational allergy secondary to inhaling lupin products.


METHODS
Subjects were interviewed using a standardized questionnaire, including demographics and current and past symptoms. They underwent skin prick tests (SPTs) to common aeroallergens and lupin products, spirometry, and off-line exhaled nitric oxide measurement. Symptomatic subjects, sensitized to lupin on SPT, underwent methacholine bronchial provocation challenge. Those with bronchial hyperresponsiveness had specific bronchial provocation challenge to lupin.


RESULTS
A total of 53/54 subjects completed testing (98%). Overall, 21% (11/53) had positive SPT results to lupin. The lupin-sensitive group had a trend toward atopy (P = .06). Seven of 11 (64%) subjects in this group were symptomatic; all had rhinitis, and 2 had wheeze. Two subjects had positive methacholine challenges, and 1 had a positive specific bronchial provocation challenge to lupin with both an early-phase and a late-phase response.


CONCLUSIONS
Allergy to inhaled lupin occurs in the workplace. A high sensitization rate on SPT was found, which correlated with symptoms. The clinical significance of cross-reactivity between legumes on SPT is unclear.


CONCLUSIONS
Sensitization to the legume, lupin, can occur from exposure at work and carries a high prevalence of clinical symptoms, which in some cases leads to occupational rhinitis and asthma.
Campbell
Charlotte P
CP
Department of Thoracic Medicine, St Vincent's Hospital, Darlinghurst, Sydney, Australia.
Jackson
Abigail S
AS
Johnson
Anthony R
AR
Thomas
Paul S
PS
Yates
Deborah H
DH
D000328:Adult; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D001985:Bronchial Provocation Tests; D003429:Cross Reactions; D003430:Cross-Sectional Studies; D007887:Fabaceae / Q000009:adverse effects* / Q000276:immunology; D005260:Female; D005525:Food-Processing Industry; D006801:Humans; D015994:Incidence; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012221:Rhinitis, Allergic, Perennial / Q000453:epidemiology* / Q000209:etiology; D012882:Skin Tests; D017132:Workplace