Pulmonary Disease in Workers Exposed to Papain: Clinical, Physiological, and Immunological Studies

摘要

The pulmonary effects of papain exposure were studied among 23 employees of a company that manufactured a soft contact lens cleaning product. Moderate to severe pulmonary symptoms were found in 12 workers. The presence of immunoglobulin-E (IgE) was correlated with decreased lung volumes and expiratory flow rates and total serum. Specific IgE and precipitating antibodies against papain were correlated with symptomology, pulmonary function test results, duration and intensity of papain exposure, and atopic history. When 5 of the 12 workers with respiratory symptoms were interviewed 4 to 11 months after job reassignment, all were asymptomatic but abnormal lung function and immunological reaction persisted. The authors concluded that papain acts as an inhalant allergen and is a potent sensitizer in humans. Pulmonary reactions involve inflammation of small airways, alveolar, and interstitial lung tissue, producing symptoms resembling bronchitis and interstitial lung disease. Immunoserological and pulmonary function monitoring is recommended for exposed workers along with the use of personal protective and engineering control measures.