PMID- 11307694
OWN - NLM
STAT- MEDLINE
DCOM- 20010510
LR  - 20190513
IS  - 0962-7480 (Print)
IS  - 0962-7480 (Linking)
VI  - 51
IP  - 2
DP  - 2001 Mar
TI  - Current best practice for the health surveillance of enzyme workers in the soap 
      and detergent industry.
PG  - 81-92
AB  - This study defines current best practice for the health surveillance of workers 
      who are potentially exposed to enzymes in the manufacture of enzymatic detergent 
      products. It is recommended that health surveillance is performed 6-monthly for 
      the first 2 years and annually thereafter. The health surveillance programme 
      should include a respiratory questionnaire to detect symptoms, assessment of lung 
      function to detect pre-symptomatic changes and an immunological test to detect 
      specific immunoglobulin E (IgE) to enzymes. The International Union Against 
      Tuberculosis and Lung Disease respiratory questionnaire should be used since it 
      has been validated extensively for detecting asthma. Operators should observe the 
      American Thoracic Society performance criteria for spirometers and standardized 
      procedures for conducting spirometry. Since current airborne monitoring 
      techniques for enzymes do not detect short-duration peak exposures, the incidence 
      of employee sensitizations remains the most reliable measure of the integrity of 
      environmental control. The Pepys skin prick test has been validated as a 
      sensitive, specific and practical test for detecting specific IgE to many 
      inhalant allergens including enzymes. For newly sensitized workers, a multi-cause 
      investigation should be conducted to identify potential sources of exposure. 
      Group results of immunological test results assist in the evaluation of workplace 
      control measures, and should be used to monitor the effectiveness of hygiene and 
      engineering programmes and to help prioritize areas for improvement. Positive 
      responses to a questionnaire or abnormal spirometry should be assessed further. 
      Occupational asthma should be excluded in any case of adult-onset asthma that 
      starts or deteriorates during working life. This is particularly important 
      because an accurate diagnosis of occupational asthma with early avoidance of 
      exposure to its cause can result in remission of symptoms and restoration of lung 
      function.
FAU - Nicholson, P J
AU  - Nicholson PJ
AD  - Procter & Gamble, Rusham Park, Whitehall Lane, Egham, Surrey TW20 9NW, UK. 
      nicholson.pj@pg.com
FAU - Newman Taylor, A J
AU  - Newman Taylor AJ
FAU - Oliver, P
AU  - Oliver P
FAU - Cathcart, M
AU  - Cathcart M
LA  - eng
PT  - Journal Article
PL  - England
TA  - Occup Med (Lond)
JT  - Occupational medicine (Oxford, England)
JID - 9205857
RN  - 0 (Detergents)
RN  - 0 (Enzymes)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Asthma/*diagnosis/physiopathology
MH  - Detergents/*adverse effects
MH  - Environmental Monitoring/*methods
MH  - Enzymes/*adverse effects
MH  - Forced Expiratory Volume/physiology
MH  - Humans
MH  - Immunoglobulin E/analysis
MH  - Immunologic Tests/methods
MH  - Occupational Diseases/*diagnosis
MH  - Professional Practice/organization & administration/standards
MH  - Respiration Disorders/*diagnosis
MH  - Skin Tests/methods
MH  - Spirometry/methods
MH  - Surveys and Questionnaires
MH  - Vital Capacity/physiology
EDAT- 2001/04/20 10:00
MHDA- 2001/05/22 10:01
CRDT- 2001/04/20 10:00
PHST- 2001/04/20 10:00 [pubmed]
PHST- 2001/05/22 10:01 [medline]
PHST- 2001/04/20 10:00 [entrez]
AID - 10.1093/occmed/51.2.081 [doi]
PST - ppublish
SO  - Occup Med (Lond). 2001 Mar;51(2):81-92. doi: 10.1093/occmed/51.2.081.