BACKGROUND: Detergents and disinfectants are an emerging cause of work-related rhinitis and asthma. These products may contain ethylenediamine tetraacetic acid (EDTA). The authors report 10 cases of EDTA-related asthma and/or rhinitis. METHODS: Review of the medical charts of patients who presented with work-related rhinitis (alone or with asthma), with a history of exposure to aerosols of EDTA-containing products and who underwent a nasal provocation test (NPT) with tetrasodium EDTA (1-4%) in our occupational health unit. RESULTS: Twenty-eight patients underwent a NPT with EDTA, which was positive in 10 cases. These patients, mostly cleaners or healthcare workers, used spray formulations of cleaning products. CONCLUSIONS: This case series is the first report of EDTA-related respiratory disease, documented by a specific test. An irritant mechanism is unlikely. Further studies are required to distinguish between an immunoallergic response and a pharmacological mechanism possibly resulting from calcium chelation, as suggested by animal experiments. A ban of spray preparations would be sufficient to prevent respiratory disease induced by EDTA inhalation, regardless of its mechanism.
BACKGROUND: Detergents and disinfectants are an emerging cause of work-related rhinitis and asthma. These products may contain ethylenediamine tetraacetic acid (EDTA). The authors report 10 cases of EDTA-related asthma and/or rhinitis. METHODS: Review of the medical charts of patients who presented with work-related rhinitis (alone or with asthma), with a history of exposure to aerosols of EDTA-containing products and who underwent a nasal provocation test (NPT) with tetrasodium EDTA (1-4%) in our occupational health unit. RESULTS: Twenty-eight patients underwent a NPT with EDTA, which was positive in 10 cases. These patients, mostly cleaners or healthcare workers, used spray formulations of cleaning products. CONCLUSIONS: This case series is the first report of EDTA-related respiratory disease, documented by a specific test. An irritant mechanism is unlikely. Further studies are required to distinguish between an immunoallergic response and a pharmacological mechanism possibly resulting from calcium chelation, as suggested by animal experiments. A ban of spray preparations would be sufficient to prevent respiratory disease induced by EDTA inhalation, regardless of its mechanism.
Authors: Niels Hadrup; Marie Frederiksen; Eva B Wedebye; Nikolai G Nikolov; Tanja K Carøe; Jorid B Sørli; Karen B Frydendall; Biase Liguori; Camilla S Sejbaek; Peder Wolkoff; Esben M Flachs; Vivi Schlünssen; Harald W Meyer; Per A Clausen; Karin S Hougaard Journal: J Appl Toxicol Date: 2021-07-11 Impact factor: 3.628