Torben Sigsgaard

Pulmonary illness as a consequence of occupational exposure to shrimp shell powder

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Randi Jacobsen Bertelsen, Department of Occupational Medicine, Haukeland University Hospital, P.O. Box 1400, N-5021 Bergen, Norway; Department of Clinical Science, University of Bergen, P.O. Box 7804, N-5020 Bergen, Norway. Electronic address: randi.j.bertelsen@uib.no.
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  • Øistein Svanes, Department of Occupational Medicine, Haukeland University Hospital, P.O. Box 1400, N-5021 Bergen, Norway; Department of Clinical Science, University of Bergen, P.O. Box 7804, N-5020 Bergen, Norway; Department of Thoracic Medicine, Haukeland University Hospital, N-5021 Bergen, Norway.
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  • Anne Mette Madsen, The National Research Centre for the Working Environment, Copenhagen Denmark.
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  • Bjørg Eli Hollund, Department of Occupational Medicine, Haukeland University Hospital, P.O. Box 1400, N-5021 Bergen, Norway; Department of Clinical Science, University of Bergen, P.O. Box 7804, N-5020 Bergen, Norway.
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  • Jorunn Kirkeleit, Department of Occupational Medicine, Haukeland University Hospital, P.O. Box 1400, N-5021 Bergen, Norway; Department of Clinical Science, University of Bergen, P.O. Box 7804, N-5020 Bergen, Norway.
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  • Torben Sigsgaard
  • Katrine Uhrbrand, The National Research Centre for the Working Environment, Copenhagen Denmark.
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  • Thien Van Do, Laboratory of Clinical Biochemistry, Haukeland University Hospital, N-5021 Bergen, Norway.
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  • Tor B Aasen, Department of Occupational Medicine, Haukeland University Hospital, P.O. Box 1400, N-5021 Bergen, Norway.
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  • Cecilie Svanes, Department of Occupational Medicine, Haukeland University Hospital, P.O. Box 1400, N-5021 Bergen, Norway; Centre for International Health, University of Bergen, N-5020 Bergen, Norway.

OBJECTIVES: An employee with no prior history of allergy or asthma, experienced respiratory and flu-like symptoms during production of shrimp shell powder in a seafood savory factory in Norway. We aimed to clarify the diagnosis and to identify the cause of the symptoms by specific inhalation challenge (SIC) and by characterizing the powder's biocontaminants, particle size fractions and inflammatory potential.

METHODS: Respiratory and immunological responses were measured the day before and after each of four challenges with 20-150g shrimp shell powder during three consecutive days. The powder was analyzed for endotoxin, microorganisms and particle size fractions by standardized laboratory methods. Total inflammatory potential was quantified by reactive oxygen species (ROS) production in a granulocyte assay.

RESULTS: The patient had elevated IgG, but not IgE, towards shrimp shell powder. 20min challenge with 150g shrimp shell powder induced 15% decrease in FVC, 23% decrease in FEV1 and increased unspecific bronchial reactivity by methacholine. Neutrophils and monocytes increased 84% and 59%, respectively, and the patient experienced temperature increase and flu-like symptoms. The shrimp shell powder contained 1118 endotoxin units/g and bacteria including Bacillus cereus, and 57% respirable size fraction when aerosolized. The ROS production was higher for shrimp shell powder than for endotoxin alone.

CONCLUSIONS: Endotoxin and other bacterial components combined with a high fraction of respirable dust might be the cause of the symptoms. The patient's characteristics and response to SIC were best compatible with occupational asthma and organic dust toxic syndrome, while hypersensitivity pneumonitis could not be excluded.

OriginalsprogEngelsk
TidsskriftEnvironmental Research
Vol/bind148
Sider (fra-til)491-9
Antal sider9
ISSN0013-9351
DOI
StatusUdgivet - jul. 2016

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