OCCUPATIONAL ASTHMA IN FRUIT SALAD PROCESSING

Background Three subjects employed in the preparation of fruit for fru it salads reported work-related respiratory symptoms. Their work entai led removing the peel from citrus fruits, primarily oranges, following soaking of the fruits in a bath of enzymes including fungal derived p ectinase and glucanase. Objectives To investigate the respiratory symp toms reported by these workers and determine their causes. Methods The three workers were investigated by a respiratory physician, including spirometry and serial peak flow measurements. Blood was taken for the measurement of IgE and IgG antibody responses against the enzyme solu tion. Results Predominant symptoms in these workers were shortness of breath, chest tightness and wheezing which were all alleviated at week ends and holidays only to occur when returning to work. Serial peak fl ow measurements showed a clear work-related pattern. All three had str ong IgE responses to the enzyme solution used at the workplace and sho wed distinct patterns of binding in immunoblots. All three improved im mensely following withdrawal from the workplace environment. Conclusio n Enzymes appear to be widely used in the preparation of fruit and alt hough they are used in liquid form, exposure can occur to induce immun ological sensitization and asthma.