L’asthme professionnel au formaldéhyde

Abstract

IntroductionFormaldehyde is a very reactive chemical molecule used in several sectors of activity and whose exposure in the workplace has revealed its allergenic nature at the origin of allergic respiratory manifestations, in particular asthma which remains relatively rare since only a few cases of formaldehyde occupational asthma has been reported in the literature. ObjectivesDescribe the socio-professional, clinical, functional and allergological characteristics of cases of allergic asthma to formaldehyde, and assess the impact of this condition on medical fitness for work. Material and methodsRetrospective study covering all cases of occupational allergic asthma with formaldehyde collected from the Department of Occupational Medicine and Occupational Pathologies of the CHU La Rabta during the period from January 1, 2000 to July 31, 2020. ResultThis is a series of 21 patients with a mean age of 42.19±6.49 years, including 15 women and 6 men. The majority belonged to the plastics industry sector (11 cases), followed by the health sector (5 cases). The average length of time in the post was 14.29±8.08 years. These were mainly workers in thermoforming/thermo-cutting of plastics (7 cases), care staff (5 cases) and heat-welding workers (4 cases). The lack of personal respiratory protection was reported by the majority of patients (17 cases). The first functional manifestations appeared on average 8±5.16 years after exposure, dominated by a typical asthma symptomatology (16 cases). Rhythmicity with labor was reported by all patients. Reversible obstructive nature or airway hyperreactivity was confirmed in 19 cases. In addition, two employees had specific IgE positive for formaldehyde. In view of the functional and allergological clinical data, the diagnosis of occupational asthma was retained in all patients, associated with rhinitis in 2 cases and we have retained by legal presumption formaldehyde as being the common etiological agent in cases of asthma. In addition, this morbidity justified the elimination of positions exposed to formaldehyde fumes for all patients, on pain of aggravation. ConclusionFormaldehyde is widely used in many forms in the workplace. Its responsibility for triggering asthma has been highlighted in several professions. To this end, it is essential to reduce exposure to formaldehyde to the lowest possible level. To achieve this, the occupational physician must ensure that primary prevention measures are reinforced.