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Minireview: Biological factors causing allergic diseases of occupational origin. Part I: Respiratory disordersJacek DutkiewiczInstitute of Dermatology, Krakow, PolandKey words: allergens, biological factors, allergic diseases, occupational diseases, bateria, fungi, plants, animals. Suggested citation format: Dutkiewicz J. Minireview: Biological factors causing allergic diseases of occupational origin. Part I: Respiratory disorders. Allergopedia. 2025; 1: 6. doi: 10.14320/allergopedia.20250106 Biological allergens causing occupational diseases are produced by a multitude of organisms and so far are less known compared to chemical ones. Thus, we feel that matching of the most important respiratory diseases against living organisms grouped in 4 taxonomical kingdoms could be useful in the search of etiological agents of respiratory disease(s) in particular occupational environments. In this paper we considered two respiratory disorders: hypersensitivity pneumonitis (HP) which is predominantly occupational disease evoked by various glycoprotein and protein allergens and bronchial asthma which is occupational in only 5-15% of all asthma cases and caused by high-molecular-weight allergens, often in 20-50 kDa range [13]. Disease: Hypersensitivity pneumonitis (HP)Kingdom: Bacteria (Eubacteria). Various species of bacteria, mostly those living as saprophytes on grain, wood and other plant materials and released into the air during processing of such materials are common causative agents of HP, usually appearing as occupational disease. Most of the pathogenic bacterial species belong into two phyla: Actinobacteria (Actinomycetota) and Proteobacteria (Gram-negative bacteria). Actinobacteria comprise filamentous bacteria of which many species, mostly thermophilic (developing at high temperatures) causes known subunits of HP: Saccharopolyspora rectivirgula and Thermoactinomyces vulgaris cause farmer’s lung due to exposure to overheated hay, grain or other plant materials [12, 18, 21], Thermobifida fusca causes mushroom compost producer’s lung due to exposure to overheated compost [15], and Laceyella (Thermoactinomyces) sacchari causes bagassosis due to exposure to bagasse (sugarcane residue) [20, 21]. Mesophilic, filamentous actinomycetes Streptomyces spp. occurring commonly in plant and soil dust may cause HP in farmers and gardeners [9]. Actinobacteria comprise also non filamentous, rod-shaped, mesophilic Gram-positive organisms of which such species as Arthrobacter globiformis and Brevibacterium linens present in grain dust [16] and Microbacterium betulae present in wood dust [19] cause HP in exposed workers. To this phylum belong also mycobacteria, of which Mycobacterium immunogenum and M. avium developing in cutting oils cause a HP entity named “machine operator’s lung” [18, 21]. Among Proteobacteria the most important HP-causing agent is Pantoea agglomerans, a Gram-mesophilic negative rod, widespread in nature, mostly on grain and wood, causing thresher’s lung [10] and HP in woodworker’s [14]. HP may be caused also by other Gram-negative bacteria, such as Alcaligenes faecalis occurring in grain, hay and herbs [16]. Kingdom: Fungi. Microfungi described as molds were often described as cause of HP. Most of them belong to genera Aspergillus (A. fumigatus, A. clavatus, A. terreus, A. umbrosus, A. versicolor) [6] and Penicillium, such as P. glabrum (frequentans) causing suberosis in cork processing workers [12] as well as P. casei, P, roqueforti and P. camemberti causing cheese washer’s disease [11]. Molds from other genera may also induce HP, such as Rhizopus microsporus var. rhizopodiformis in Scandinavian woodworkers [7]. Common budding yeast (Saccharomyces cerevisiae) were identified as a cause of HP in farmer [8]. HP could be evoked as well by exposure to button mushroom (Agaricus bisporus) and oyster mushroom (Pleurotus ostreatus) spores in mushroom growers [8]. Kingdom: Plants (Plantae). With few exceptions, plants themselves are rarely reported as causative agents of HP. Such exception may be stipatosis, after exposure to esparto grass [20]. Kingdom: Animals (Animalia). The most important HP subunit is bird fancier’s lung caused by the inhalation of dust contaminated with birds’ epithelia, faeces and feathers, mostly originated from pigeons and budgerigars kept as hobbies, less frequently from hens, ducks, turkeys and pheasants [5]. There is only little evidence indicating causing HP by allergens originating from mammals and from arthropods. Disease: Bronchial Asthma (BA)Kingdom: Bacteria (Eubacteria). Bacteria were identified as a cause of intrinsic asthma (caused by strains developing in human body), but only little is known about the role of bacteria in causing extrinsic asthma evoked by allergens present in external air, including those in occupational premises. Kingdom: Fungi. Molds belonging to genera Aspergillus (A. flavus, A. fumigatus), Penicillium and other genera (Alternaria spp., Chaetomium spp., Cladosporium spp.) are frequent cause of asthma in agricultural workers [7]. Asthma in farmers may be induced also by fungi parasitizing on wheat, such as Puccinia graminis, Ustilago spp. and Tilletia spp. [4-7]. Enzymes of Aspergillus oryzae and Aspergillus niger, as well as common budding yeast (Saccharomyces cerevisiae) used in the baking industry, may lead to occupational asthma in bakers [8, 9]. Kingdom: Plants (Plantae). In contrast to HP, plant particles represent a common cause of BA. Asthma may caused by the work-related inhalation of dust released during processing of various crop plants (tea, coffee, rice, buckwheat, soya, castor bean), vegetables (artichoke, asparagus, dill, garlic, pea), spices (thyme, rosemary, cinnamon, anise, sesame) and as well as industrial and forage plants (rapeseed, sunflower, lupine, poppy) [8, 11]. There are also reports describing the cases of occupational BA after respiratory exposure to pulverized tissues of plants used as medications, such as narrowleaf plantain (Plantago lanceolata) or ipecacuanha (Carapichea ipecacuanha) used as emetic [8], as well as after exposure to dust plant proteases used in food industry such as papaya from papaya fruits or bromelin from pineapple fruits [8, 11]. Dust from flowers, such as chrysanthemums, cloves, roses, tulips, hyacinths, lilies and freesias may cause occupational asthma in circa 8% of greenhouse flowers and ornamental plant growers [17]. Even more hazardous is exposure to wood dust that may be a cause of asthma in 6-18% workers [1]. Kingdom: Animals (Animalia). Allergens of poultry (epithelia, feathers, feces) may cause asthma among breeders [2], whereas hen egg proteins cause this disease in workers processing egg mass [6]. However, in contrast to HP, BA may occur in a wide range of occupations under respiratory exposure to other vertebrates and to invertebrates. Thus, asthma occurs in farmers breeding mammals, caused by allergenic proteins present in pig urine as well as in cow hair and dander [6]. The workers breeding rats and mice in scientific laboratories are under the risk of Laboratory Animal Allergy (LAA) caused by exposure to aerosol of urine and dander of bred rodents [3]. Asthma cases were described in workers exposed to fish meal and to droplet aerosol of processed salmon protein [8]. BA cases were also described among workers producing sea food from marine invertebrates: mussels, crabs and cephalopods [8, 11]. Finally, exposure of people working in stores of agricultural products are under risk of store mites asthma caused by the inhalation of feces and body particles of small (0.3-0.75 mm) mites feeding on stored products: Acarus siro, Tyrophagus putrescentiae, Lepidoglyphus destructor and Glycyphagus domesticus. ConclusionThe occurrence of the type of occupational allergy (hypersensitivity pneumonitis - HP or bronchial asthma - BA) depends to large extent on the qualitative classification of allergen-producing organisms. Allergens produced by bacteria cause usually HP, very rarely BA. By contrast, allergens of plant and animal origin (except for those produced by birds) usually cause BA and rarely HP. The only organisms that seem to cause HP and BA to similar extent are fungi and aforementioned birds. References
DisclaimerThe above description does not exhaust all possible exposures and symptoms, and the hapten you are allergic to may also be present in other sources not listed above.Therefore, always check the composition of the products and substances you come into contact with, and if in doubt, consult a licensed physician, preferably a dermatologist or allergist.
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