title: Sodium metabisulphite induced airways disease in the fishing and fish-processing industry.
abstract: BACKGROUND
  Sodium metabisulphite (SMBS) is recognized as a potential cause of airway irritation and possibly occupational asthma, but awareness of its use in the fishing and fish-processing industry is low.
  
  
  OBJECTIVE
  To describe three cases of occupational airways disease due to SMBS exposure and to review the literature.
  
  
  RESULTS
  Three patients, one trawlerman and two prawn processors, developed work-related airways disease due to exposure to SMBS, one with irritant-induced asthma with a positive-specific bronchial challenge associated with very high sulphur dioxide exposures, one with occupational asthma and one with vocal cord dysfunction and underlying asthma. Of the nine cases recorded in the literature, most were non-atopic and responses to specific bronchial challenge when undertaken showed an immediate response. Exposures to sulphur dioxide in these settings are very high, in excess of 30 ppm.
  
  
  CONCLUSIONS
  SMBS should be regarded as a cause of occupational airways disease and its use in the fish and prawn-processing industry investigated further to better identify risks from exposure and handling of the agent in the workplace.
authors.affiliation: Department of Environmental & Occupational Medicine, University of Aberdeen, Aberdeen AB25 2ZP, UK. m.steiner@abdn.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: Steiner
authors.forename: A
authors.initials: A
authors.lastname: Scaife
authors.forename: S
authors.initials: S
authors.lastname: Semple
authors.forename: G
authors.initials: G
authors.lastname: Hulks
authors.forename: J G
authors.initials: JG
authors.lastname: Ayres
mesh_terms: D000328:Adult; D000818:Animals; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis; D016535:Bronchial Hyperreactivity; D001985:Bronchial Provocation Tests; D005260:Female; D005399:Fishes; D005525:Food-Processing Industry; D006801:Humans; D007509:Irritants / Q000009:adverse effects*; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis; D016273:Occupational Exposure; D013447:Sulfites / Q000009:adverse effects*
chemical_list: D007509:Irritants; D013447:Sulfites; C005200:sodium metabisulfite