DIETHANOLAMINE-INDUCED OCCUPATIONAL ASTHMA, A CASE-REPORT

Background Amino alcohols are low molecular weight chemicals used wide ly in industrial processes, often as minor constituents. They have bee n found to cause allergic contact dermatitis. Marked exposure through airways is uncommon in other than occupational settings where chemical s containing amino alcohols may be heated or vaporized, liberating fre e amino alcohols into the ambient air. A few cases of asthma and aller gic rhinitis have been reported, but the amounts inducing the airway r eactions have not been defined. Objective To further characterize etha nolamine-induced asthma and define the concentration inducing the asth matic reaction, a case of diethanolamine-induced occupational asthma i n a patient handling diethanolamine containing cutting fluid is report ed. Methods Suspicion of work related asthma was raised by symptoms an d peak expiratory flow monitorings at work and at home. Specific bronc hial provocation tests with the cutting fluid containing DEA and with DEA aerosal at two different concentration below the American Conferen ce of Governmental Industrial Hygienists threshold limit value of DEA (2.0 mg/m(3)) were done. Results DEA caused asthmatic airway obstructi on at two different concentrations below the ACGIH TLV. A slight dose- response relationship was observed. Specific IgE-antibodies against DE A could not be found. Conclusions DEA is able to induce occupational a sthma by a sensitization mechanism, the exact pathophysiological mecha nism of which is not known.