Work-related allergy and asthma in spice mill workers - The impact of processing dried spices on IgE reactivity patterns.
BACKGROUND
Three spice mill workers developed work-related allergy and asthma after prolonged exposure to high levels (>10 mg/m(3)) of inhalable spice dust. Patterns of sensitization to a variety of spices and putative allergens were identified.


METHODS
Work-related allergy and asthma were assessed on history, clinical evaluation, pulmonary function and fractional exhaled nitric oxide. Specific IgE reactivity to a range of common inhalant, food and spice allergens was evaluated using ImmunoCAP and allergen microarray. The presence of non-IgE-mediated reactions was determined by basophil stimulation (CAST-ELISA). Specific allergens were identified by immunoblotting to extracts of raw and dried processed garlic, onion and chili pepper.


RESULTS
Asthma was confirmed in all 3 subjects, with work-related patterns prominent in worker 1 and 3. Sensitization to multiple spices and pollen was observed in both atopic workers 1 and 2, whereas garlic and chili pepper sensitization featured in all 3 workers. Microarray analysis demonstrated prominent profilin reactivity in atopic worker 2. Immunoblotting demonstrated a 50-kDa cross-reactive allergen in garlic and onion, and allergens of approximately 40 and 52 kDa in chili pepper. Dry powdered garlic and onion demonstrated greater IgE binding.


CONCLUSIONS
This study demonstrated IgE reactivity to multiple spice allergens in workers exposed to high levels of inhalable spice dust. Processed garlic and onion powder demonstrated stronger IgE reactivity than the raw plant. Atopy and polysensitization to various plant profilins, suggesting pollen-food syndrome, represent additional risk factors for sensitizer-induced work-related asthma in spice mill workers.
Centre for Occupational and Environmental Health Research, University of Cape Town, South Africa.
Anita
A
van der Walt
Andreas L
AL
Lopata
Natalie E
NE
Nieuwenhuizen
Mohamed F
MF
Jeebhay
D000328:Adult; D000402:Airway Obstruction / Q000503:physiopathology; D052179:Antigens, Plant / Q000276:immunology; D001249:Asthma / Q000175:diagnosis / Q000209:etiology / Q000276:immunology* / Q000503:physiopathology; D015153:Blotting, Western; D001985:Bronchial Provocation Tests; D002212:Capsicum / Q000737:chemistry / Q000276:immunology; D005260:Female; D005511:Food Handling; D005520:Food Preservatives; D005541:Forced Expiratory Volume / Q000502:physiology; D005737:Garlic / Q000737:chemistry / Q000276:immunology; D006801:Humans; D006967:Hypersensitivity; D006969:Hypersensitivity, Immediate / Q000276:immunology; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D019570:Inhalation Exposure; D008168:Lung / Q000378:metabolism / Q000503:physiopathology; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D009784:Occupational Diseases / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D019697:Onions / Q000737:chemistry / Q000276:immunology; D010366:Peak Expiratory Flow Rate / Q000502:physiology; D010936:Plant Extracts / Q000276:immunology; D010940:Plant Proteins / Q000276:immunology; D011058:Pollen / Q000276:immunology; D040081:Protein Array Analysis; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D012882:Skin Tests; D017365:Spices / Q000009:adverse effects; D013147:Spirometry
D052179:Antigens, Plant; D005520:Food Preservatives; D010936:Plant Extracts; D010940:Plant Proteins; D009569:Nitric Oxide; D007073:Immunoglobulin E