Occupational asthma caused by exposure to cyanoacrylate

Background: Exposure to acrylates may give rise to rhinitis and asthma in b oth industrial and domestic environments. The mechanisms underlying these r espiratory conditions caused by acrylates remain largely unknown. Methods: We studied two assembly operators exposed to cyanoacrylate glue wh o developed rhinitis and asthma symptoms. The causal relationship of these symptoms to cyanoacrylate glue exposure was investigated by serial peak exp iratory flow (PEF) monitoring at work and off work. Moreover, inhalation te sting was performed by asking the patients to mimic exposure at work with t he cyanoacrylate glue in a 7-m(3) challenge chamber. Results: Serial PEF monitoring at work and away from work was consistent wi th occupational asthma in both patients. The methacholine inhalation test w as negative in patient 1 (off work) and showed bronchial hyperresponsivenes s in patient 2. After 20-min exposure to cyanoacrylate, the patients had la te and progressive asthmatic reactions, respectively, and the methacholine test became positive in patient 1. Induced-sputum samples obtained 3 and 24 h after the cyanoacrylate challenge showed a marked increase in sputum eos inophils. Conclusions: Exposure to cyanoacrylate in these patients provoked not only variable airflow limitation and bronchial hyperresponsiveness, but also pro nounced eosinophilia in sputum.