Current Allergy & Clinical Immunology

Dr Do-a-lot asks her students if they know what antibodies are. She receives a variety of responses, from ‘Immunoglobulins’ to ‘The good guys that protect our bodies from the bad guys.’ She asks them to return in a week with a summary.

Health workers are exposed to a wide range of chemicals used for cleaning and disinfection. This trend has been largely attributed to the ever-increasing demand for effective cleaning and disinfection in hospital settings in an effort to prevent healthcare-associated infections. This review summarises recent findings on the association between workrelated asthma and exposure to cleaning agents in healthcare settings. The review found an increasing body of evidence linking cleaning agents to adverse work-related health effects such as rhinitis, asthma and contact dermatitis. There is, however, little information on the specific cleaning agents and tasks associated with various asthma-related outcomes. In addition, few studies have conducted quantitative exposure assessments for cleaning agents in the healthcare setting. Furthermore, limited information exists regarding exposure-response relationships between the frequency of exposure to specific cleaning agents and asthma–related outcomes. There is a need for larger prospective studies in health workers exposed to cleaning agents using various clinical, physiological and inflammatory markers in order to characterise further the asthma phenotypes and the risk factors (environmental, individual) associated with these outcomes in these workers. A specific focus on and understanding of work-related dermatitis associated with such agents and its relationship to the adverse respiratory outcomes also deserves further study.

Smodingium argutum is an indigenous tree in the family Anacardiaceae. It is considered to be the most common cause of plant contact dermatitis in South Africa. Four children were seen with a characteristic ‘poison-ivy type’ rash caused by contact with this tree. In each child the cause of the rash and the nature, duration and distribution of the rash were virtually identical. The natural distribution of Smodingium argutum in South Africa and its recognition as an important cause of plant dermatitis are presented. The allergenic component found in the leaves and sap of the Smodingium argutum tree has been identified as a C17-catechol, related to the Urushiol found in American poison ivy.