Papain-induced occupational rhinoconjunctivitis and asthma – A case report
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Nofer Institute of Occupational Medicine / Instytut Medycyny Pracy im. prof. J. Nofera, Łódź, Poland (Department of Occupational Diseases and Environmental Health / Klinika Chorób Zawodowych i Zdrowia Środowiskowego)
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Diana Tymoszuk   

Nofer Institute of Occupational Medicine, Department of Occupational Diseases and Environmental Health, św. Teresy 8, 91-348 Łódź, Poland
Med Pr Work Health Saf. 2016;67(1):109-12
This report presents a case of occupational asthma, rhinitis and conjunctivitis to papain in a 50-year-old herbs and spices packer, with documented increased eosinophilia in induced sputum and in the nasal lavage fluids after a specific inhalation challenge test (SICT) and specific nasal challenge test (SNCT) with this enzyme. Immunoglobulin E-mediated (IgE) sensitization to papain was confirmed by positive results of a skin prick test with specific solution. Specific inhalation and nasal challenge tests demonstrated a direct and significant link between the exposure to this protease and the allergic response from the respiratory system. Additionally, the SNCT induced a severe reaction of the conjunctivae and a significant increase in the count of eosinophils in tears, despite the lack of direct contact of the allergen with the conjunctiva. Med Pr 2016;67(1):109–112
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