Occupational asthma in nurses handling psyllium

Clin Allergy. 1987 Jan;17(1):1-6. doi: 10.1111/j.1365-2222.1987.tb02313.x.

Abstract

Five nurses aged 31-55 years old had a history of asthmatic symptoms after being exposed to psyllium that they prepared and distributed to patients. They had been nurses for 9-20 years and had reported asthmatic symptoms related to work in the past 3-12 months. They reported symptoms of rhinoconjunctivitis and all were atopic but only one had a previous history of asthma. Four of the five tested subjects had an immediate skin reaction to a commercial psyllium extract. All had IgE antibodies to psyllium. At the time that they were investigated, four out of the five had a significant increase in bronchial responsiveness to methacholine (PC 20 less than 8 mg/ml). Inhalation challenges with psyllium caused isolated immediate (one subject) and dual reactions (three subjects). One subject exposed for only 1 min to the psyllium powder experienced a severe immediate bronchospastic reaction, which required intubation for 3 h with complete functional recovery thereafter. This experience illustrates the precautions necessary, with the inclusion of a cautious dose-response approach, even with an 'occupation-type' challenge in the laboratory.

MeSH terms

  • Adult
  • Antibody Specificity
  • Asthma / etiology*
  • Asthma / immunology
  • Bronchial Provocation Tests
  • Female
  • Humans
  • Immunoglobulin E / immunology
  • Male
  • Middle Aged
  • Nursing
  • Occupational Diseases / etiology*
  • Occupational Diseases / immunology
  • Psyllium / adverse effects*
  • Psyllium / immunology

Substances

  • Immunoglobulin E
  • Psyllium