title: Occupational rhinitis and asthma due to EDTA-containing detergents or disinfectants.
abstract: BACKGROUND
  Detergents and disinfectants are an emerging cause of work-related rhinitis and asthma. These products may contain ethylenediamine tetraacetic acid (EDTA). The authors report 10 cases of EDTA-related asthma and/or rhinitis.
  
  
  METHODS
  Review of the medical charts of patients who presented with work-related rhinitis (alone or with asthma), with a history of exposure to aerosols of EDTA-containing products and who underwent a nasal provocation test (NPT) with tetrasodium EDTA (1-4%) in our occupational health unit.
  
  
  RESULTS
  Twenty-eight patients underwent a NPT with EDTA, which was positive in 10 cases. These patients, mostly cleaners or healthcare workers, used spray formulations of cleaning products.
  
  
  CONCLUSIONS
  This case series is the first report of EDTA-related respiratory disease, documented by a specific test. An irritant mechanism is unlikely. Further studies are required to distinguish between an immunoallergic response and a pharmacological mechanism possibly resulting from calcium chelation, as suggested by animal experiments. A ban of spray preparations would be sufficient to prevent respiratory disease induced by EDTA inhalation, regardless of its mechanism.
authors.affiliation: AP-HP, Paris Poison Centre, Occupational and Environmental Health Unit, Fernand Widal Hospital, Paris, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Laborde-Castérot
authors.forename: Antoine F
authors.initials: AF
authors.lastname: Villa
authors.forename: Nicole
authors.initials: N
authors.lastname: Rosenberg
authors.forename: Patricia
authors.initials: P
authors.lastname: Dupont
authors.forename: Hwee Min
authors.initials: HM
authors.lastname: Lee
authors.forename: Robert
authors.initials: R
authors.lastname: Garnier
mesh_terms: D000328:Adult; D000336:Aerosols; D059366:Asthma, Occupational / Q000139:chemically induced* / Q000175:diagnosis; D002614:Chelating Agents / Q000009:adverse effects*; D003902:Detergents / Q000009:adverse effects* / Q000737:chemistry; D004202:Disinfectants / Q000009:adverse effects* / Q000737:chemistry; D004492:Edetic Acid / Q000009:adverse effects*; D005260:Female; D006282:Health Personnel; D006796:Household Work; D006801:Humans; D008297:Male; D008875:Middle Aged; D009299:Nasal Provocation Tests; D009784:Occupational Diseases / Q000139:chemically induced / Q000175:diagnosis; D016273:Occupational Exposure / Q000009:adverse effects*; D012220:Rhinitis / Q000139:chemically induced* / Q000175:diagnosis
chemical_list: D000336:Aerosols; D002614:Chelating Agents; D003902:Detergents; D004202:Disinfectants; D004492:Edetic Acid