A longitudinal study of possible allergy to enzyme detergents

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Abstract
Subjects (136) with asthma and/or hay fever were surveyed for possible sensitization to the Bacillus licheniformis protease protease present in the commerical antigenically identical enzymes (Alcalase and Maxatase) used in household detergents. Prick-test reactions reported as minimally positive were given by 1 subject to both commerical enzyme preparations at the same standard, nonirritating concentrations and by 4 others to one but not the other antigenically identical enzyme. Two of the 5, and an additional 7, gave weak prick tests to the purified enzyme (Koch-Light Protease) at test protein concentrations 100 times stronger and to which non-specific irritation occurs. The findings are strongly against interpretation of these reactions as positive and were on no occasion comparable with those in sensitive workers. The skin-test reactions are attributable to nonspecific effects. Neither enzyme-specific RAST (radioallergosorbent test) IgE tests nor clinical histories suggested clinical sensitivity. Enzyme-specific RAST IgE for 88 subjects over a period of 5 yr showed no correlation with exposure. None had developed specific IgE levels like those of sensitized subjects and prick-test-negative workers. The 8 with the largest increase in specific IgE were prick-test-negative and their clinical reaction to enzyme detergents were comparable to those of non-enzyme detergents. There is no evidence from this study that exposure to modern, non-dusty household enzyme-containing detergents is likely to lead to clinical sensitization.