Purpose of Review
Occupational allergic diseases (OAD) such as occupational contact dermatitis (OCD), occupational asthma (OA), and occupational rhinitis (OR) are the most prevalent occupational diseases in industrialized countries. The purpose of this review is to provide an update about the main occupational metal and solvent exposures related to allergy and airway diseases and to discuss newly defined causative agents and industries in this field.
Currently for over 400 causative agents for OA and OCD, several hundreds of agents for OR have been identified. Although many studies have reported an overall decline in OAD related to known agents after implementation of efficient and effective workplace preventive measures, the constant development of new products continuously introduces to the market potential unknown respiratory hazards. Workplace allergens are often high molecular weight (HMW) agents that are > 10 kDa molecular weight and capable of eliciting IgE sensitization. Sensitizing low molecular weight (LMW) agents are often reactive chemicals. Metals and solvents are two large causative agent groups related to OADs that mainly behave as LMW (< 10 kDa) sensitizers and/or irritants.
Avoidance of causative exposures through control strategies is the primary prevention approach for OADs. These strategies must be applied and covered for all known and newly defined causative agents. This review aims to summarize current status of known occupational metal and solvent exposures related to allergy and airway diseases and to discuss newly defined causative agents and industries in this field.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Walters GI, Kirkham A, McGrath EE, Moore VC, Robertson AS, Burge PS. Twenty years of SHIELD: decreasing incidence of occupational asthma in the West Midlands, UK? Occup Environ Med. 2015;72(4):304–10.
Cartier A. New causes of immunologic occupational asthma, 2012-2014. Curr Opin Allergy Clin Immunol. 2015;15(2):117–23.
Suojalehto H, Karvala K, Ahonen S, Ylinen K, Airaksinen L, Suuronen K, et al. 3-(Bromomethyl)-2-chloro-4-(methylsulfonyl)- benzoic acid: a new cause of sensitiser induced occupational asthma, rhinitis and urticaria. Occup Environ Med. 2018;75(4):277–82.
Anderson SE, Long C, Dotson GS. Occupational allergy. Eur Med J (Chelmsf). 2017;2(2):65–71.
Gotzev S, Lipszyc JC, Connor D, Tarlo SM. Trends in occupations and work sectors among patients with work-related asthma at a Canadian tertiary care clinic. Chest. 2016;150(4):811–8.
Folletti I, Siracusa A, Paolocci G. Update on asthma and cleaning agents. Curr Opin Allergy Clin Immunol. 2017;17(2):90–5.
•• Lau A, Tarlo SM. Update on the management of occupational asthma and work-exacerbated asthma. Allergy, Asthma Immunol Res. 2019;11(2):188–200. This review provides an Update on the Management of Occupational Asthma and Work-Exacerbated Asthma.
Mazurek JM, Weissman DN. Occupational respiratory allergic diseases in healthcare workers. Curr Allergy Asthma Rep. 2016;16(11):77.
Lipińska-Ojrzanowska A, Walusiak-Skorupa J, Nowakowska-Świrta E, Wiszniewska M. Predicting occupational allergy in culinary and hairdressing apprentices. Occup Med (Lond). 2020;70(1):68–71.
Merget R, Pham N, Schmidtke M, Casjens S, van Kampen V, Sander I, et al. Medical surveillance and long-term prognosis of occupational allergy due to platinum salts. Int Arch Occup Environ Health. 2017;90(1):73–81.
Jeebhay MF, Moscato G, Bang BE, Folletti I, Lipinska-Ojrzanowska A, Lopata AL, et al. Food processing and occupational respiratory allergy- an EAACI position paper. Allergy. 2019;74(10):1852–71.
Tang EA, Matsui E, Wiesch DG, Samet JM. Epidemiology of asthma and allergic diseases. In: Adkinson NF, Bochner BS, Busse WW, Holgate ST, Lemanske RF, Simins ES, eds. Middleton's Allergy: Principles and Practice. 7th ed. Philadelphia: Elsevier; 2009. p. 715–67.
Scadding GK, Kariyawasam HH, Scadding G, Mirakian R, Buckley RJ, Dixon T, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007). Clin Exp Allergy. 2017;47(7):856–89.
Bjerg A, Eriksson J, Olafsdottir IS, Middelveld R, Franklin K, Forsberg B, et al. The association between asthma and rhinitis is stable over time despite diverging trends in prevalence. Respir Med. 2015;109(3):312–9.
Balogun RA, Siracusa A, Shusterman D. Occupational rhinitis and occupational asthma: association or progression? Am J Ind Med. 2018;61(4):293–307.
• Stevens WW, Grammer LC 3rd. Occupational rhinitis: an update. Curr Allergy Asthma Rep. 2015;15(1):487. Useful update on OR.
Pacheco KA. Occupational dermatitis: how to identify the exposures, make the diagnosis, and treat the disease. Ann Allergy Asthma Immunol. 2018;120(6):583–91.
Grammer LC, Harris KE. Occupational immunologic lung disease and occupational rhinitis. In: Grammer LC, Greenberger PA, editors. Patterson’s allergic diseases. 8th ed. Philadelphia: Wolters Kluwer; 2018. p. 584–93.
Lei DK, Grammer LC. Occupational immunologic lung disease. Allergy Asthma Proc. 2019;40(6):418–20.
Quirce S, Vandenplas O, Campo P, Cruz MJ, de Blay F, Koschel D, et al. Occupational hypersensitivity pneumonitis: an EAACI position paper. Allergy. 2016;71(6):765–79.
•• Wyman AE, Hines SE. Update on metal-induced occupational lung disease. Curr Opin Allergy Clin Immunol. 2018;18(2):73–9. This article provides a nice update on metal-induced occupational lung disease.
Budinger L, Hertl M. Immunologic mechanisms in hypersensitivity reactions to metal ions: an overview. Allergy. 2000;55(2):108–15.
•• Schubert S, Brans R, Reich A, Hansen A, Buhl T, Skudlik C, et al. Assessment of occupational exposure and spectrum of contact sensitization in metalworkers with occupational dermatitis: results of a cohort study within the OCCUDERM project. J Eur Acad Dermatol Venereol. 2019. https://doi.org/10.1111/jdv.16130. This is a more recent review on OCD.
Sensitizing agents inducers of occupational asthma, hypersensitivity pneumonitis and eosinophilic bronchitis: World Allergy Organization; updated July 2019. Available from: https://www.worldallergy.org/education-and-programs/education/allergic-disease-resource-center/professionals/sensitizing-agents-inducers-of-occupational-asthma. Accessed 15 Apr 2020.
• Exposure Code List: The Association of Occupational and Environmental Clinics [Available from: http://www.aoecdata.org/ExpCodeLookup.aspx. Accessed 15 Apr 2020. This list is the largest and most comprehensive one which contains occupationally related asthmagens.
Rosenman KD, Beckett WS. Web based listing of agents associated with new onset work-related asthma. Respir Med. 2015;109(5):625–31.
Crewe J, Carey R, Glass D, Peters S, Abramson MJ, Benke G, et al. A comprehensive list of asthmagens to inform health interventions in the Australian workplace. Aust N Z J Public Health. 2016;40(2):170–3.
Huang X, Xie J, Cui X, Zhou Y, Wu X, Lu W, et al. Association between concentrations of metals in urine and adult asthma: a case-control study in Wuhan, China. PLoS One. 2016;11(5):e0155818.
Seed MJ, Agius RM. Progress with structure-activity relationship modelling of occupational chemical respiratory sensitizers. Curr Opin Allergy Clin Immunol. 2017;17(2):64–71.
Ahlstrom MG, Thyssen JP, Wennervaldt M, Menne T, Johansen JD. Nickel allergy and allergic contact dermatitis: a clinical review of immunology, epidemiology, exposure, and treatment. Contact Dermatitis. 2019;81(4):227–41.
Frosch PJ, John SM. Clinical Aspects of Irritant Contact Dermatitis. In: Johansen JD, Frosch P, Lepoittevin JP, eds. Contact Dermatitis. 6th ed. Springer-Verlag Berlin Heidelberg; 2011. p. 305–45
Wiszniewska M, Walusiak-Skorupa J. Recent trends in occupational contact dermatitis. Curr Allergy Asthma Rep. 2015;15(7):43.
Burge PS. Hypersensitivity pneumonitis due to metalworking fluid aerosols. Curr Allergy Asthma Rep. 2016;16(8):59.
Linna A, Oksa P, Palmroos P, Roto P, Laippala P, Uitti J. Respiratory health of cobalt production workers. Am J Ind Med. 2003;44(2):124–32.
Le Moual N, Zock JP, Dumas O, Lytras T, Andersson E, Lillienberg L, et al. Update of an occupational asthma-specific job exposure matrix to assess exposure to 30 specific agents. Occup Environ Med. 2018;75(7):507–14.
Szram J, Schofield SJ, Cosgrove MP, Cullinan P. Welding, longitudinal lung function decline and chronic respiratory symptoms: a systematic review of cohort studies. Eur Respir J. 2013;42(5):1186–93.
Storaas T, Zock JP, Morano AE, Holm M, Bjornsson E, Forsberg B, et al. Incidence of rhinitis and asthma related to welding in Northern Europe. Eur Respir J. 2015;46(5):1290–7.
Taghiakbari M, Castano R, Parfi AA, Achore M, El-Zein M, Rhazi MS, et al. A cross-sectional assessment of rhinitis symptoms and nasal patency in relation to welding exposure. Am J Respir Crit Care Med. 2018;198(7):958–61.
Yi J, LeBouf RF, Duling MG, Nurkiewicz T, Chen BT, Schwegler-Berry D, et al. Emission of particulate matter from a desktop three-dimensional (3D) printer. J Toxicol Environ Health A. 2016;79(11):453–65.
Viitanen A-K, Uuksulainen S, Koivisto AJ, Hämeri K, Kauppinen T. Workplace measurements of ultrafine particles—a literature review. Ann Work Expo Health. 2017;61(7):749–58.
Petrarca C, Di Giampaolo L, Pedata P, Cortese S, Di Gioacchino M. Engineered nanomaterials and occupational allergy. In: Otsuki T, Petrarca P, Gioacchino M, eds. Allergy and Immunotoxicology in Occupational Health. 1st ed. Singapore: Springer; 2017. p. 27–46.
Uter W, Larese Filon F, Rui F, Balato A, Wilkinson M, Krecisz B, et al. ESSCA results with nickel, cobalt and chromium, 2009-2012. Contact Dermatitis. 2016;75(2):117–21.
Hedberg YS. Metal allergy: chromium. In: Chen JK, Thyssen JP, editors. Metal allergy: from dermatitis to implant and device failure. Cham: Springer International Publishing; 2018. p. 349–64.
Lejding T, Mowitz M, Isaksson M, Bruze M, Ponten A, Svedman C, et al. A retrospective investigation of hexavalent chromium allergy in southern Sweden. Contact Dermatitis. 2018;78(6):386–92.
Hedberg YS, Gumulka M, Lind ML, Matura M, Liden C. Severe occupational chromium allergy despite cement legislation. Contact Dermatitis. 2014;70(5):321–3.
Hedberg YS, Liden C. Chromium(III) and chromium(VI) release from leather during 8 months of simulated use. Contact Dermatitis. 2016;75(2):82–8.
Bregnbak D, Thyssen JP, Zachariae C, Johansen JD. Characteristics of chromium-allergic dermatitis patients prior to regulatory intervention for chromium in leather: a questionnaire study. Contact Dermatitis. 2014;71(6):338–47.
Haluza D, Moshammer H, Hochgatterer K. Dust is in the air. Part II: effects of occupational exposure to welding fumes on lung function in a 9-year study. Lung. 2014;192(1):111–7.
Hannu T, Piipari R, Tuppurainen M, Nordman H, Tuomi T. Occupational asthma caused by stainless steel welding fumes: a clinical study. Eur Respir J. 2007;29(1):85–90.
Walters GI, Moore VC, Robertson AS, Burge CB, Vellore AD, Burge PS. An outbreak of occupational asthma due to chromium and cobalt. Occup Med (Lond). 2012;62(7):533–40.
Diepgen TL, Ofenloch RF, Bruze M, Bertuccio P, Cazzaniga S, Coenraads PJ, et al. Prevalence of contact allergy in the general population in different European regions. Br J Dermatol. 2016;174(2):319–29.
Kolberg L, Forster F, Gerlich J, Weinmayr G, Genuneit J, Windstetter D, et al. Nickel allergy is associated with wheezing and asthma in a cohort of young German adults: results from the SOLAR study. ERJ Open Res. 2020;6(1):00178–2019. Published 2020 Feb 3.
Tsao YC, Chang YC, Gu PW, Tzeng IS, Luo JJ. Characteristics of decreased pulmonary function and clinical symptoms in nickel electroplating workers. J Occup Environ Med. 2018;60(4):337–42.
Julander A. Metal Allergy: Cobalt. In: Chen JK, Thyssen JP, eds. Metal allergy: from dermatitis to implant and device failure. 1st ed. Cham: Springer International Publishing; 2018. p. 365–73.
Walters GI, Robertson AS, Moore VC, Burge PS. Cobalt asthma in metalworkers from an automotive engine valve manufacturer. Occup Med (Lond). 2014;64(5):358–64.
Zereini F, Wiseman CLS. Platinum metals in the environment. In: Vitkova M, Chu DB, Koellenperger G, Hann S, editors. Speciation analysis of chloroplatinates. London: Springer; 2015. p. 97–108.
Linde SJL, Franken A, du Plessis JL. Occupational respiratory exposure to platinum group metals: a review and recommendations. Chem Res Toxicol. 2017;30(10):1778–90.
WHO. Platinum. Air Quality Guidelines for Europe. 2nd ed. Copenhagen: World Health Organization Regional Office for Europe; 2000. p. 166–9.
Lehmann DM, Williams WC. Cross-reactivity between halogenated platinum salts in an immediate-type respiratory hypersensitivity model. Inhal Toxicol. 2018;30(11–12):472–81.
Heederik D, Jacobs J, Samadi S, van Rooy F, Portengen L, Houba R. Exposure-response analyses for platinum salt-exposed workers and sensitization: a retrospective cohort study among newly exposed workers using routinely collected surveillance data. J Allergy Clin Immunol. 2016;137(3):922–9.
• Bains SN, Fonacier L. Irritant contact dermatitis. Clin Rev Allergy Immunol. 2019;56(1):99–109. This article provides a nice overview of irritant CD.
Shakik S, Arrandale V, Holness DL, MacLeod JS, McLeod CB, Peter A, et al. Dermatitis among workers in Ontario: results from the occupational disease surveillance system. Occup Environ Med. 2019;76(9):625–31.
Dumas O, Despreaux T, Perros F, Lau E, Andujar P, Humbert M, et al. Respiratory effects of trichloroethylene. Respir Med. 2018;134:47–53.
Maesano CN, Caillaud D, Youssouf H, Banerjee S, Prud'Homme J, Audi C, et al. Indoor exposure to particulate matter and volatile organic compounds in dwellings and workplaces and respiratory health in French farmers. Multidiscip Respir Med. 2019;14:33.
Benedict RT, Roney N, Faroon O, Williams RL, Ashizawa A, Carlson-Lynch H, et al. Toxicological profile for tetrachloroethylene (PERC). 2019. Available from: https://www.atsdr.cdc.gov/ToxProfiles/tp18.pdf.
Alif SM, Dharmage S, Benke G, Dennekamp M, Burgess J, Perret JL, et al. Occupational exposure to solvents and lung function decline: a population based study. Thorax. 2019;74(7):650–8.
Hwang S, Lee KJ, Park JB. Pulmonary function impairment from exposure to mixed organic solvents in male shipyard painters. J Occup Environ Med. 2018;60(12):1057–62.
Kurt OK, Ergun D, Basaran N. Can the ceramic industry be a new and hazardous sector for work-related asthma? Respir Med. 2018;137:176–80.
Teitelbaum DT. Introduction to toxicology: occupational & environmental. In: Katzung BG ed. Basic & Clinical Pharmacology. 14th ed. New York: McGraw-Hill; 2018. p. 1003–19.
Singthong S, Pakkong P, Choosang K, Wongsanit S. Occupational health risks among trichloroethylene-exposed workers in a clock manufacturing factory. Global J Health Sci. 2014;7(1):161–72.
Paraskevaidou K, Porpodis K, Kontakiotis T, Kioumis I, Spyratos D, Papakosta D. Asthma and rhinitis in Greek furniture workers. Journal of Asthma. 2019 Oct 16:1–10.
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This article is part of the Topical Collection on Asthma
About this article
Cite this article
Kurt, O.K., Basaran, N. Occupational Exposure to Metals and Solvents: Allergy and Airway Diseases. Curr Allergy Asthma Rep 20, 38 (2020). https://doi.org/10.1007/s11882-020-00931-7
- Occupational allergic diseases
- Occupational contact dermatitis
- Occupational asthma
- Occupational rhinitis