marianne kuiper milks on tue 13 jun 06
Hello everyone,
What Carl, my husband, wrote may be of interest to some or all,
although I suspect that many of you are well-informed on the subject.
As one should be. It's a bit late because I had trouble getting it
from Point A to Point B.
Marianne
Dear Mary et al
This is a general response to all who use glazes in their work, from
an allergist's point of view. I offer this background not for diagnosis
but for information on where to start to sort out and hopefully prevent
more serious problems in the future. The information is given as small
payback for all the information given to my wife Marianne.
Background: Occupational allergy (OA) is a common complication of the
workplace and has been implicated in 5-10% of allergic diseases of the
eyes, nose, skin, and lungs both in asthma and hypersensitive
pneumonitis. There are other dangers for the ceramist including
poisoning, burns, and chronic lung disease from inhaling fibers and
silicon and other dusts. I am sure there are others who know more about
this than I do. Many things cause irritant or toxic reactions which can
be thought of as symptoms of burning or tearing or nausea, etc.
Simplistically, I usually think of allergic reactions as causing
itching of the affected site.
Occupational allergens are separated into high-molecular weight
allergens(usually organic compounds), irritants and low-molecular
weight agents, of which the last would be more likely to apply to
ceramists. Sensitization "is dependent on the physiochemical properties
of the inhaled agent, level and duration of exposure, host factors and
industrial hygiene practices." The prevention, "diagnosis", and
treatment are inherent in this statement. For example pre-existing
allergies and smoking both predispose a person to develop an allergic
reaction. If someone has an existing nickel allergy( earring or cheap
jewelry rashes) they are more likely to develop other contact allergy
especially to related metals.
There are two types of allergy that have direct applicability to your
profession - immediate and delayed. The immediate type is from
antibodies that sit on the mast cell. The mast cell is the cell that
contains histamine, which fights infectious agents and is an important
part of the immune system. When exposed to the offending allergen it
releases histamine and others noxious substances which cause itching,
rashes, sneezing, watery eyes, nose and wheezing or
bronchoconstriction. An example would be someone allergic to cats. It
takes 7-10 days to develop this type of (new) reaction, but antibodies
are made and rest on the mast cell so with re-exposure the reaction is
from minutes to hours. This can be irritating or life threatening and
should never be ignored because what can initially be only eye or nasal
symptoms can progress to asthma (especially in smokers), which is of
course much more dangerous and potentially career ending. The delayed
type is more commonly seen on the skin but can also involve the lungs.
It is a reaction of the immune system that constantly monitors our
environment and ourselves for potential threats from without and
within. The chemical or organism is picked up from the skin or mucous
membranes by ingesting cells, processed, and carried to regional lymph
nodes where it is presented to the 10,000,000,000 different, specific
lymphocytes to see if our immune system should ignore or attack it. The
very term allergy comes from the Greek word strange, indicating a
reaction of the immune system to something that is not a potential
threat to our system. (I don't think anyone should be allergic to
seafood or grass pollen, i.e.: they don't make any sense.) An example
of this type of reaction would be a nickel or poison ivy reaction.
Because it takes longer to be sensitized, and after re-exposure it
takes hours to days for a reaction, it is usually more difficult to
identify the culprit.
Common chemicals implicated in OA are acid anhydrides, isocyanates,
plicatic acid, glutaraldehyde,persulfates, and platinum, nickel and
chromium salts. Look at your glaze recipes and try to pay attention to
which chemicals produce symptoms. Timing of symptoms in relationship to
changes in routine can yield important clues to the cause of a problem.
Remember latex is a common allergy if you wear gloves when working. If
you are prone to allergy use vinyl. An allergist may be able to help
but you may need to go to an Allergy Department in a teaching hospital
to get the time and interest required to sort this out. It depends on
your local allergist's interests and curiosity because this can be
challenging and uncharted waters.
In summary: be careful, take care of your body, be clean, wear good,
well fitting masks, pay attention to warnings, and seek professional
help before you need to give up something you love or need for
professional support. The treatment of allergy is to find out what you
are allergic to, where to find those allergens, avoid them, if that
doesn't work avoid them even more, and use medication, if you must, to
control symptoms. Drugs are never the best solution, especially with
occupational allergy. Good luck! I hope this wasn't more than you
needed or wanted.
Unfortunately, for legal reasons, I cannot give you information on
testing. It would be wrong for me to venture beyond the information I
tried to help you with.
You can learn to test for specific chemicals and compounds, but this
should be done only under strict supervision of a board-certified
allergist.
Carl J. Milks M.D. Asthma, Allergy and Immunology.
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