Occupational allergy in the production of drugs

Quinazoline oxide--an intermediate in chlordiazepoxide synthesis--is the most potent contact allergen in the pharmaceutical industry. Penicillins proved to be potent allergens. Conditions of the technological process favor development of hypersensitivity to tetracyclines. No single case of allergy to erythromycin was noted. In case of employees hypersensitive to disulfiram and aminophylline cross reactions with compounds of similar structure were observed. The authors discuss also some problems concerning contact allergy in all persons occupationally dealing with various medicines.     

Infectious allergy

The allergic reactivity which accompanies various infectious diseases is different in certain fundamental principles from the allergic disease associated with hypersensitivity to such agents as pollens, dust, and foods. Allergic sensitivity associated with tuberculosis comes about because of the participation of a fatty fraction of the bacillus with another component of the bacterium which is acutally the sensitizing substance. The fatty fraction, if isolated from the bacillus, can act with various kinds of sensitizing substances that have nothing to do with tuberculosis to bring about the same kind of hypersensitivity that accompanies tuberculosis. Attempts are being made to learn more about the manner of action of this factor, and also to find out whether the organisms of other infectious diseases may have similar chemical constituents that cause allergic disease.     

Contact allergy from Frullania and respiratory allergy from Thuja

Occupational allergic contact dermatitis in 52 forest-workers was caused by sesquiterpene lactones from liverworts (Frullania) and by usnic acid from lichens which grow on various trees including cedar (Thuja). Occupational asthma and rhinitis in 35 wood-workers was caused by wood dust of western red cedar (Thuja plicata). Characteristically, the respiratory symptoms occurred in the evening and at night and not during working hours; inhalation challenge with plicatic acid from the wood provoked immediate, late or dual (combined immediate and late) asthmatic reactions. Another class of compounds, tropolones, derived from Thuja plicata wood, was responsible for dermatitis in a wood-worker. These distinct industrial hazards in two groups of workers at the tree-felling and wood-working levels in the forest-products industry can be identified by clinical history and examination supplemented by specific cutaneous or respiratory clinical investigation.