Occupational allergy in nurses to a bulk laxative

Finely ground psyllium (Plantago ovata) seeds, so-called ispaghula powder is used in bulk laxatives. During the dispensing of these medicines some dust is generated. Allergic symptoms from exposure to this dust was reported by two nurses, one of whom was wroking in a department where exposure to the powder could be considered high. Nineteen other subjects working in the same department were investigated with regard to allergy to ispaghula powder. An extract from ispaghula powder was made and used in RAST and skin tests. Exposure tests with ispaghula powder mixed with crushed rusks were made in symptomatic subjects. Eight out of the 20 investigated subjects from this department reported symptoms which could possibly have been elicited by ispaghula powder. Evidence of sensitization was found in five of them. The use of less dusty (granulated) forms of ispaghula laxatives might diminish the risk of sensitization.