A case of occupational rhinitis caused by porcine pancreatic extract developing into occupational asthma

Safety evaluation of the food enzyme triacylglycerol lipase from the pregastric tissues of calves, young goats and lambs

The food enzyme containing triacylglycerol lipase (triacylglycerol acylhydrolase; EC 3.1.1.3) is prepared from the pregastric tissues of calves, young goats and lambs by Caglificio Clerici SpA. The food enzyme is intended to be used in the production of cheese. As no concerns arose from the animal source of the food enzyme, from its manufacture and based on the history of safe use and consumption, the Panel considered that toxicological data were not required and no exposure assessment was necessary. A search for the similarity of the amino acid sequence of the food enzyme to known allergens was made and no match was found. The Panel considered that a risk of allergic reactions upon dietary exposure cannot be excluded, but the likelihood is low. Based on the data provided, the Panel concluded that this food enzyme does not give rise to safety concerns under the intended conditions of use.

Safety evaluation of the food enzyme triacylglycerol lipase from non-genetically modified Limtongozyma cylindracea strain MS-5-OF

The food enzyme triacylglycerol lipase (triacylglycerol acylhydrolase, EC 3.1.1.3) is produced with the non-genetically modified yeast Limtongozyma cylindracea strain MS-5-OF by Meito Sangyo Co., Ltd. The food enzyme is free from viable cells of the production organism. It is intended to be used in five food manufacturing processes: brewing processes, baking processes, milk processing for cheese production, production of free fatty acids by hydrolysis and production of flavouring preparations from dairy products. Dietary exposure to the food enzyme-total organic solids (TOS) was estimated to be up to 1.033 mg TOS/kg body weight (bw) per day in European populations. Genotoxicity tests did not indicate a safety concern. The systemic toxicity was assessed by means of a repeated dose 90-day oral toxicity study in rats. The Panel identified a no observed adverse effect level of 2,084 mg TOS/kg bw per day, the highest dose tested, which, when compared with the estimated dietary exposure, results in a margin of exposure of at least 2,017. A search for the similarity of the amino acid sequence of the food enzyme to known allergens was made and no match was found. The Panel considered that a risk of allergic reactions by dietary exposure cannot be excluded, but the likelihood is low. Based on the data provided, the Panel concluded that this food enzyme does not give rise to safety concerns under the intended conditions of use.

Safety evaluation of the food enzyme triacylglycerol lipase from the non-genetically modified Rhizopus arrhizus strain AE-TL(B)

The food enzyme triacylglycerol lipase (triacylglycerol acylhydrolase; EC 3.1.1.3) is produced with the non-genetically modified Rhizopus arrhizus strain AE-TL(B) by Amano Enzyme Inc. The food enzyme was considered free from viable cells of the production organism. It is intended to be used in the modification of fats and oils by interesterification and in the manufacture of enzyme-modified dairy ingredients. Dietary exposure to the food enzyme-total organic solids (TOS) was estimated to be up to 0.057 mg TOS/kg body weight (bw) per day in European populations. Genotoxicity tests did not indicate a safety concern. The systemic toxicity was assessed by means of a repeated dose 90-day oral toxicity study in rats. The Panel identified a no observed adverse effect level of 1,960 mg TOS/kg bw per day, the highest dose tested, which, when compared with the estimated dietary exposure, resulted in a margin of exposure of at least 34,386. A search for the similarity of the amino acid sequence of the food enzyme to known allergens was made and no match found. The Panel considered that, under the intended conditions of use, the risk of allergic reactions upon dietary exposure cannot be excluded, but the likelihood is low. Based on the data provided, the Panel concluded that this food enzyme does not give rise to safety concerns, under the intended conditions of use.

Safety evaluation of the food enzyme rennet paste from the abomasum of suckling goats, lambs and calves

The food enzyme rennet paste containing chymosin (EC 3.4.23.4), pepsin A (EC 3.4.23.1) and triacylglycerol lipase (triacylglycerol acylhydrolase, EC 3.1.1.3) is prepared from the abomasum of suckling goats, lambs and calves by Caglificio Clerici S.p.A. The food enzyme is intended to be used in milk processing for cheese production. As no concerns arise from the animal source of the food enzyme, from its manufacture, and based on the history of safe use and consumption, the Panel considers that toxicological data were not required and no exposure assessment was necessary. On the basis of literature data, the Panel considers that, under the intended conditions of use, the risk of allergic sensitisation and elicitation reactions by dietary exposure could not be excluded, but the likelihood is considered to be low. Based on the data provided, the Panel concludes that this food enzyme does not give rise to safety concerns under the intended conditions of use.

Occupational Respiratory Allergic Diseases in Healthcare Workers

Healthcare workers (HCWs) are exposed to a range of high and low molecular weight agents that are allergic sensitizers or irritants including cleaners and disinfectants, natural rubber latex, and various medications. Studies have shown that exposed HCWs are at risk for work-related rhinitis and asthma (WRA). Work-related rhinitis may precede development of WRA and should be considered as an early marker of WRA. Avoidance of causative exposures through control strategies such as elimination, substitution, engineering controls, and process modification is the preferred primary prevention strategy for preventing development of work-related allergic diseases. There is limited evidence for the effectiveness of respirators in preventing occupational asthma. If sensitizer-induced WRA is diagnosed, it is important to avoid further exposure to the causative agent, preferably by more rigorous application of exposure control strategies to the workplace. This review focuses on allergic occupational respiratory diseases in HCWs.

Occupational allergy to pharmaceutical products

PURPOSE OF REVIEW

Occupational allergy in healthcare workers is common and can lead to significant costs from both loss of productivity within the workforce as well as those associated with diagnosis and treatment. This review aims to provide an update on drugs implicated in causing occupational allergy.

RECENT FINDINGS

Drugs traditionally reported as causing occupational allergy, such as penicillin, remain problematic. However, as their use reduces and newer drugs, such as cephalosporins, are used more frequently there is a changing pattern to occupational sensitization. In some studies up to 17% of healthcare workers now appear sensitized to cephalosporins. Other drug classes also reported include proton pump inhibitors and benzodiazepines. Interestingly, drugs such as omeprazole and tetrazepam rarely cause allergy in patients but can be very sensitizing if applied topically or inhaled. Recent studies involving pharmaceutical company employees show that this problem can no longer be considered primarily related to healthcare workers.

SUMMARY

The diagnosis of occupational allergy to drugs can be complicated and has been shown to take up to 5 years from the onset of symptoms. Ultimately, workplace avoidance remains key; however, an up to date awareness of culprit drugs and the patterns of allergy seen are key to a prompt resolution of symptoms.

Occupational rhinitis: an update

Occupational rhinitis is characterized by nasal congestion, rhinorrhea, nasal itching, and/or sneezing that occur secondary to exposures in the workplace. This disease can be classified into allergic or nonallergic subgroups based upon the underlying disease pathogenesis as well as the type of causative agent. While the true prevalence of occupational rhinitis is unknown, there are certain professions and occupational exposures that place workers at a higher risk for developing the disease. Additionally, occupational rhinitis can be associated with occupational asthma and upper airway symptoms may precede those of the lower respiratory tract. Taken together, occupational rhinitis is an important disease for study given its medical as well as socioeconomic implications. This review will focus on the classification of occupational rhinitis as well the prevalence, diagnosis, and treatment strategies.

Occupational rhinitis: consensus on diagnosis and medicolegal implications

PURPOSE OF REVIEW

Work-related rhinitis is a common disease in many working groups, frequently associated with asthma. The purpose of this review is to summarize the specific literature published within the past 12 months, to discuss the diagnostic workup and to illustrate the medicolegal aspects pertaining to this disease.

RECENT FINDINGS

Recently, there has been a growing scientific interest in work-related rhinitis, which includes both occupational rhinitis and work-exacerbated rhinitis. The epidemiological relevance and the relationships to asthma have been evaluated. New etiologic agents and populations at risk have been identified. A new definition and classification, and a diagnostic algorithm, have been proposed.

SUMMARY

In consideration of the epidemiological relevance and of the medicolegal implications, occupational rhinitis should be considered in daily clinical practice by all physicians. In adults with late-onset rhinitis, occupational causes should be queried and patients in whom an occupational association is suspected should be referred for specific assessments.