| Bromelains consist of a group of proteolytic enzymes of Bromeliaceae.
They are commonly used in pharmaceutical industries, food production
and in diagnostic laboratories. Bromelains are known to cause IgE-
mediated reactions of both the immediate type and the 'late phase
reaction of immediate type reaction' with predominantly respiratory
symptoms. We report four cases of occupational allergy to bromelain
in workers of a blood grouping laboratory. These observations
prompted us to investigate the sensitization rate to bromelain in all
workers of the particular diagnostic laboratory who had contact with
bromelain. These results were compared with those obtained from
healthy, randomly selected individuals without evident bromelain
exposure. Our findings indicate that (i) bromelain is a strong
sensitizer, (ii) sensitization usually occurs due to inhalation and
not to ingestion, (iii) bromelain allergy is occupationally acquired,
and adequate precautions are necessary. We can further state that
(iv) skin testing with relatively pure allergens such as isolated
proteases like bromelain may induce systemic reactions, even at very
high dilutions.
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