title: Is the incidence of aliphatic amine-induced occupational rhinitis and asthma underestimated?
abstract: BACKGROUND
  Amines, some of which are known to cause asthma, are frequently present in the work environment, but are rarely identified as being responsible for occupational rhinitis (OR) or asthma (OA). However, amine-induced OR/OA may be underreported. To discuss this hypothesis, we report a series of patients with positive amine-specific nasal provocation test (NPT).
  
  
  METHODS
  Review of the medical charts of 37 patients with OR (alone or associated with asthma), submitted to a NPT with an aliphatic or alicyclic amine (except for EDTA) present in a product used at work.
  
  
  RESULTS
  Most patients worked in the healthcare sector or for a cleaning company. Amines were mostly present in cleaning products. Seven patients had a positive NPT. NPTs were positive for the following amines: bis(aminopropyl)laurylamine, C12-C18 alkyldimethylamine oxides, bis(2-hydroxyethyl)tallowamine oxides, 3-dimethylaminopropylamine, 2,2'-dimethyl-4,4'-methylene-bis(cyclohexylamine), lauryldimethylamine oxide. NPTs were negative for the following amines: monoethanolamine, diethanolamine, triethanolamine, isopropanolamine, triethylamine, triethylenetetramine, aminopropyltriethoxysilane, alkylpropylenediamineguanidine acetate.
  
  
  CONCLUSIONS
  The frequency of amine-induced OR/OA may be underestimated, particularly when cleaning products are incriminated. Comprehensive investigation of all cases is mandatory to ensure an efficient prevention policy and consequently a good clinical and socio-occupational prognosis of occupational respiratory disease.
authors.affiliation: AP-HP, Hôpitaux Universitaires Saint-Louis Lariboisière Fernand-Widal, Consultation de Pathologie Professionnelle et Environnementale, Paris, France; Sorbonne Paris Cité, Univ Paris 13, Bobigny, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Laborde-Castérot
authors.forename: Nicole
authors.initials: N
authors.lastname: Rosenberg
authors.forename: Patricia
authors.initials: P
authors.lastname: Dupont
authors.forename: Robert
authors.initials: R
authors.lastname: Garnier
mesh_terms: D000328:Adult; D000588:Amines / Q000009:adverse effects*; D059366:Asthma, Occupational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009299:Nasal Provocation Tests; D009784:Occupational Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D012220:Rhinitis / Q000139:chemically induced* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000588:Amines
keywords: amines; cleaning products; nasal provocation test; occupational asthma; occupational rhinitis