Respiratory hazards from papain

Late-onset asthma occurred in a non-atopic worker in a factory where papain powder was packed. The patient had had 3 attacks of asthma since first being exposed to atmospheric papain dust. He gave a positive immediate reaction to skin-prick tests with solutions of papain which were appreciably weaker than solutions which caused no reaction in unexposed individuals. These results, together with his history and the fact that symptoms stopped when he was not exposed to papain, suggest that he had extrinsic allergic asthma caused by sensitisation to papain. Shortly after re-exposure to papain a worker in another factory died during an attack of asthma. Measures to prevent the inhalation of papain dust must be taken in factories where papain is handled, not only to avoid the proteolytic effects of the material but also to prevent workers from becoming sensitised.