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ENZYME DETERGENTS

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Classification   |    Detailed evidence-based information

Substances Included Synonyms

Therapeutic Toxic Class

    A) Proteolytic or amylolytic enzymes are used in laundry detergents and presoaks to loosen soil and remove stains. The enzymes are obtained by fermentation of selected strains of Bacillus subtilis (Alcalase) or Bacillus licheniformis (Esperase).
    B) Commercial raw enzyme material contains 5% to 15% of proteolytic enzyme, 8% to 30% protein, and 8% to 60% inorganic salts, primarily sodium chloride and sodium or calcium sulfate. When incorporated into household products, the final enzyme concentration is 0.08% to 1.0% in detergents and 1.2% to 5.0% in presoaks.
    C) Contact lens products may contain enzymes for digesting protein from soft contact lenses.

Specific Substances

    1) ENZYME LAUNDRY DETERGENTS
    2) ENZYME PRESOAKS
    3) LAUNDRY DETERGENTS, ENZYME
    4) DETERGENTS, ENZYME
    5) DETERGENT (ENZYME)
    6) BACILLUS SUBTILIS ENZYMES

Available Forms Sources

    A) FORMS
    1) Enzymes are found in various laundry detergents and presoaks. A typical formulation consists of:
    a) LAUNDRY DETERGENTS
    1) Linear alkylate sulphonate - 15% to 20%
    2) Sodium tripolyphosphate - 45% to 50%
    3) Sodium sulfate - 10% to 15%
    4) Sodium silicate - 5% to 10%
    5) Perfume
    6) Colorings
    7) Optical brighteners
    8) Enzyme - 0.08% to 1%
    b) PRESOAK
    1) Nonionic surfactant - 2% to 10%
    2) Builder - 60% to 75%
    3) Sodium perborate - 20% to 30%
    4) Enzyme - 1.2% to 5%
    2) Contact lens products may contain enzymes for digesting protein from soft contact lenses.
    a) Pancreatin
    b) Papain
    c) Subtilisin
    B) USES
    1) Proteolytic or amylolytic enzymes are used in laundry detergents and presoaks to loosen soil and remove stains.
    2) Bacillus subtilis has been used by the US military in training exercises to simulate an anthrax attack using a relatively innocuous substance. It is released into the air as part of a biological weapons training program in the US military bases (Allen, 2000). Fermentation of some strains of Bacillus subtilis produces proteolytic enzymes used in detergents.

Overview

Life Support

    A) This overview assumes that basic life support measures have been instituted.

Clinical Effects

    0.2.1) SUMMARY OF EXPOSURE
    A) These products contain enzymes, detergents, and builders which have irritating and sensitizing properties. Ingestion is likely to result in emesis. Occupational exposure to high concentrations may produce asthma or dermatitis, but these are unlikely in routine household use.
    1) Granulated detergents are less toxic than powdered formulations to sensitized individuals, due to encapsulation or beading of the enzyme.
    B) Contact lens products may contain enzymes for digesting protein from soft contact lens. Ingestion of a single tablet may result in GI irritation or a hypersensitivity reaction. Ocular exposure may produce conjunctival irritation and corneal haziness. No reports of toxicity could be found.
    0.2.4) HEENT
    A) Moderate conjunctival irritation may occur with ocular exposure of pure enzyme material or 1 to 10% detergent solutions.
    0.2.5) CARDIOVASCULAR
    A) Chest pain and or tachycardia may be noted during asthmatic episodes.
    0.2.6) RESPIRATORY
    A) Minor upper respiratory symptoms may occur at low dust levels with inhalational exposure.
    B) Exposure to high dust concentrations as in industrial spillage can produce dose related asthma, with symptoms of lacrimation, rhinorrhea, pharyngitis, cough, and wheezing after inhalational exposure.
    C) Very extreme exposure results in dyspnea, choking and cyanosis. Cough and wheezing are usually delayed for about 6 to 8 hours after exposure, with nocturnal dyspnea being common.
    D) Immediate hypersensitivity may also occur. The risk of asthma during domestic use is extremely small due to newer low-dust formulations.
    0.2.8) GASTROINTESTINAL
    A) Nausea and vomiting is expected following acute ingestion of either pure enzymes or enzyme detergent combinations.
    0.2.14) DERMATOLOGIC
    A) Dermatitis is due to primary irritation and is generally seen on moist or friction body areas such as palms of hands, fingertips, and face where in contact with respirators.

Laboratory Monitoring

    A) Chest x-ray may be useful in evaluating respiratory reactions or symptoms.

Treatment Overview

    0.4.2) ORAL/PARENTERAL EXPOSURE
    A) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting.
    B) Emesis is usually spontaneous. Syrup of ipecac-induced emesis is NOT indicated due to lack of systemic toxicity and the potential for froth to block the airway, as well as the risk of aspiration.
    C) DIAGNOSIS - The skin prick test or RAST test may be used to monitor work place exposure.
    D) Bronchodilators may provide symptomatic relief for asthmatic reactions.
    E) Chest x-ray may be useful in symptomatic patients.
    0.4.3) INHALATION EXPOSURE
    A) INHALATION: Move patient to fresh air. Monitor for respiratory distress. If cough or difficulty breathing develops, evaluate for respiratory tract irritation, bronchitis, or pneumonitis. Administer oxygen and assist ventilation as required. Treat bronchospasm with an inhaled beta2-adrenergic agonist. Consider systemic corticosteroids in patients with significant bronchospasm.
    0.4.4) EYE EXPOSURE
    A) DECONTAMINATION: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, the patient should be seen in a healthcare facility.
    0.4.5) DERMAL EXPOSURE
    A) OVERVIEW
    1) DECONTAMINATION: Remove contaminated clothing and jewelry and place them in plastic bags. Wash exposed areas with soap and water for 10 to 15 minutes with gentle sponging to avoid skin breakdown. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).
    2) Workers should frequently wash exposed areas with soap and water, and use rubber gloves with cotton lining when handling raw enzymes.
    3) Topical mild hydrocortisone creams may provide symptomatic relief.

Range Of Toxicity

    A) There are limited human data. Rapid emesis was the only effect seen in dogs ingesting 6 mg to 2.5 g/kg of enzyme detergents or pre-soaks.

Clinical Effects

Summary Of Exposure

    A) These products contain enzymes, detergents, and builders which have irritating and sensitizing properties. Ingestion is likely to result in emesis. Occupational exposure to high concentrations may produce asthma or dermatitis, but these are unlikely in routine household use.
    1) Granulated detergents are less toxic than powdered formulations to sensitized individuals, due to encapsulation or beading of the enzyme.
    B) Contact lens products may contain enzymes for digesting protein from soft contact lens. Ingestion of a single tablet may result in GI irritation or a hypersensitivity reaction. Ocular exposure may produce conjunctival irritation and corneal haziness. No reports of toxicity could be found.

Heent

    3.4.1) SUMMARY
    A) Moderate conjunctival irritation may occur with ocular exposure of pure enzyme material or 1 to 10% detergent solutions.
    3.4.3) EYES
    A) CONJUNCTIVITIS - Pure enzyme material or 1 to 10% solutions produced moderate conjunctival irritation and transient corneal haziness, clearing in 2 to 4 days in rabbit studies (Griffith et al, 1969). Products tested included Ajax(R), Bold(R), Drive(R), Gain(R), Punch(R), Tide XK(R), Amaze(R), Axion(R), Biz(R) and Sure(R).
    B) IRRITATION - Slight rhinitis or eye irritation were the only symptoms in 6 enzyme-sensitive patients challenged with granulated enzyme detergent. Symptoms correlated with elevated RAST titers against subtilisin (Zetterstorm, 1977).
    1) Rapid rinsing with water usually prevented corneal involvement. Eye irritation can occur from enzyme dust (Berlin et al, 1970).

Cardiovascular

    3.5.1) SUMMARY
    A) Chest pain and or tachycardia may be noted during asthmatic episodes.
    3.5.2) CLINICAL EFFECTS
    A) CHEST PAIN
    1) Chest pain may be noted following dust inhalation.
    B) TACHYARRHYTHMIA
    1) Tachycardia may be noted during asthmatic episodes (McMurrain, 1970).

Respiratory

    3.6.1) SUMMARY
    A) Minor upper respiratory symptoms may occur at low dust levels with inhalational exposure.
    B) Exposure to high dust concentrations as in industrial spillage can produce dose related asthma, with symptoms of lacrimation, rhinorrhea, pharyngitis, cough, and wheezing after inhalational exposure.
    C) Very extreme exposure results in dyspnea, choking and cyanosis. Cough and wheezing are usually delayed for about 6 to 8 hours after exposure, with nocturnal dyspnea being common.
    D) Immediate hypersensitivity may also occur. The risk of asthma during domestic use is extremely small due to newer low-dust formulations.
    3.6.2) CLINICAL EFFECTS
    A) BRONCHOSPASM
    1) Minor upper respiratory symptoms may occur at low dust levels with inhalational exposure to various detergents. The risk of respiratory sensitization to enzyme detergents during domestic use is extremely small due to the encapsulated or beaded form of the enzyme, however cases have been reported from older powder formulations (Berlin et al, 1970).
    2) Encapsulated Esperase was responsible for sensitization in some exposed workers, who developed pulmonary function test changes, respiratory symptoms, and evidence of IgE antibodies on RAST testing (Liss et al, 1984).
    3) Exposure to high concentrations, such as an industrial spillage, can produce IgE-mediated dose-related asthma. Usual symptoms include lacrimation, rhinorrhea, pharyngitis, cough and wheezing. Nocturnal dyspnea is common (McMurrain, 1970).
    4) Very extreme exposure resulted in dyspnea, choking and cyanosis. Principal symptoms are dyspnea and fatigue (McMurrain, 1970).
    5) Cough and wheezing usually are delayed, appearing several hours after completion of the work shift. Onset may occur within a few minutes of first exposure, but is generally delayed about 8 hours (Flindt, 1969).
    6) Two types of asthma have been described. Immediate asthma occurred 10 to 15 minutes after exposure, lasted 1 to 3 hours, and was usually seen in atopic individuals. Non-immediate asthma developed slowly over 6 to 8 hours, lasted up to 24 hours, and was usually seen in non-atopics. Some individuals have both types (Flindt, 1969).
    7) INCIDENCE - In an 11-year study of 2800 workers employed in the manufacture of enzyme detergents, occupational asthma was noted in 4.5% (Flood et al, 1985).
    B) PNEUMONITIS
    1) Hypersensitivity pneumonitis was described in a family after remodeling an old bathroom. Analysis of the wood chips and dust yielded cultures of Bacillus subtilis. Two members had positive skin tests to Bacillus subtilis vegetative cells and enzymes (Johnson et al, 1980).
    C) EMPHYSEMA
    1) Clinical emphysema has not been described, but decreases in elastic recoil in heavily exposed workers were observed in 13 subjects. Partial recovery may have occurred in some cases after terminating exposure (Musk & Gandevia, 1976).
    D) BRONCHITIS
    1) Rales without change in ventilatory capacity were observed in 3 workers after aerosol enzyme challenge (Mitchell & Gandevia, 1971).

Gastrointestinal

    3.8.1) SUMMARY
    A) Nausea and vomiting is expected following acute ingestion of either pure enzymes or enzyme detergent combinations.
    3.8.2) CLINICAL EFFECTS
    A) NAUSEA AND VOMITING
    1) Nausea and vomiting is expected following acute ingestion.

Dermatologic

    3.14.1) SUMMARY
    A) Dermatitis is due to primary irritation and is generally seen on moist or friction body areas such as palms of hands, fingertips, and face where in contact with respirators.
    3.14.2) CLINICAL EFFECTS
    A) DERMATITIS
    1) Dermatitis is due to primary irritation and not contact sensitization. The lesions are generally on palms of hands, calluses and finger tips, and the face where in contact with the respirator. Moisture and friction are needed to solubilize and activate the enzyme. The skin is red and moist (Ducksbury & Dave, 1970).
    2) Extreme exposure to enzyme detergents by home help employees resulted in primary hand irritation with edema and blistering. The incidence of dermatitis was 6.8% in the group of 314 workers (Ducksbury & Dave, 1970).
    3) CASE REPORT - Acute spongiotic dermatitis was reported in a bakery worker after handling B. subtilis derived enzyme tablets for a prolonged period of time. Tenderness, vesiculation, and fissuring of both palms were noted. The patient was treated with oral prednisone for 3 weeks and the dermatitis resolved over 6 months. Other workers with similar problems were also reported (Smith et al, 1989).
    B) LACK OF EFFECT
    1) SENSITIZATION - No signs of sensitization resulted from patch tests in 1,478 subjects (Griffith, 1969).

Immunologic

    3.19.2) CLINICAL EFFECTS
    A) ACUTE ALLERGIC REACTION
    1) A study of 136 atopic subjects with asthma and/or hay fever resulted in weekly positive prick tests in 12; only 1 of these had a raised RAST level (Pepys et al, 1985).

Laboratory Monitoring

Monitoring Parameters Levels

    4.1.1) SUMMARY
    A) Chest x-ray may be useful in evaluating respiratory reactions or symptoms.
    4.1.2) SERUM/BLOOD
    A) BLOOD/SERUM CHEMISTRY
    1) No specific lab work (CBC, electrolytes) is needed unless otherwise clinically indicated.
    4.1.4) OTHER
    A) OTHER
    1) PULMONARY FUNCTION TESTS
    a) Pulmonary function tests or measurement of peak flow may be indicated in patients with respiratory signs or symptoms such as cough, difficulty breathing, tachypnea, wheezing, or hypoxia.

Radiographic Studies

    A) CHEST RADIOGRAPH
    1) Chest x-ray may be useful in evaluating respiratory reactions or symptoms.

Methods

    A) OTHER
    1) A RAST test has been developed to detect IgE antibodies in sensitized workers (Dor et al, 1986).

Treatment

Life Support

    A) Support respiratory and cardiovascular function.

Monitoring

    A) Chest x-ray may be useful in evaluating respiratory reactions or symptoms.

Oral Exposure

    6.5.1) PREVENTION OF ABSORPTION/PREHOSPITAL
    A) DILUTION -
    1) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting (Caravati, 2004).
    B) EMESIS/ NOT RECOMMENDED -
    1) Emesis is usually spontaneous. Syrup of ipecac-induced emesis is NOT indicated due to lack of systemic toxicity and the potential for froth to block the airway, as well as the risk of aspiration.
    C) ACTIVATED CHARCOAL -
    1) There is no evidence that activated charcoal adsorbs enzymes or other detergent ingredients. Therefore, it should only be given if there is a suspicion for significant co-ingestants.
    6.5.2) PREVENTION OF ABSORPTION
    A) DILUTION
    1) DILUTION: If no respiratory compromise is present, administer milk or water as soon as possible after ingestion. Dilution may only be helpful if performed in the first seconds to minutes after ingestion. The ideal amount is unknown; no more than 8 ounces (240 mL) in adults and 4 ounces (120 mL) in children is recommended to minimize the risk of vomiting (Caravati, 2004).
    B) EMESIS
    1) Emesis is usually spontaneous. Syrup of ipecac-induced emesis is NOT indicated due to lack of systemic toxicity and potential for froth to block the airway.
    C) ACTIVATED CHARCOAL
    1) There is no evidence that activated charcoal adsorbs enzymes or other detergent ingredients.
    6.5.3) TREATMENT
    A) MONITORING OF PATIENT
    1) The skin prick test or RAST test may be used to monitor the response level to the enzyme in the workplace (Dor et al, 1986). Skin tests should not be concentrated due to primary irritation. Initial testing is with 1:100,000 solution (0.01 mg/mL). For intradermal tests use 0.02 ml of 1:10,000 (0.1 mg/mL) solution.
    2) Chest x-ray and pulmonary function testing or peak flow measurement may be useful in patients with respiratory signs or symptoms.
    B) BRONCHODILATOR
    1) BRONCHOSPASM SUMMARY
    a) Administer beta2 adrenergic agonists. Consider use of inhaled ipratropium and systemic corticosteroids. Monitor peak expiratory flow rate, monitor for hypoxia and respiratory failure, and administer oxygen as necessary.
    2) ALBUTEROL/ADULT DOSE
    a) 2.5 to 5 milligrams diluted with 4 milliliters of 0.9% saline by nebulizer every 20 minutes for three doses. If incomplete response, administer 2.5 to 10 milligrams every 1 to 4 hours as needed OR administer 10 to 15 milligrams every hour by continuous nebulizer as needed. Consider adding ipratropium to the nebulized albuterol; DOSE: 0.5 milligram by nebulizer every 30 minutes for three doses then every 2 to 4 hours as needed, NOT administered as a single agent (National Heart,Lung,and Blood Institute, 2007).
    3) ALBUTEROL/PEDIATRIC DOSE
    a) 0.15 milligram/kilogram (minimum 2.5 milligrams) diluted with 4 milliliters of 0.9% saline by nebulizer every 20 minutes for three doses. If incomplete response administer 0.15 to 0.3 milligram/kilogram (maximum 10 milligrams) every 1 to 4 hours as needed OR administer 0.5 mg/kg/hr by continuous nebulizer as needed. Consider adding ipratropium to the nebulized albuterol; DOSE: 0.25 to 0.5 milligram by nebulizer every 20 minutes for three doses then every 2 to 4 hours as needed, NOT administered as a single agent (National Heart,Lung,and Blood Institute, 2007).
    4) ALBUTEROL/CAUTIONS
    a) The incidence of adverse effects of beta2-agonists may be increased in older patients, particularly those with pre-existing ischemic heart disease (National Asthma Education and Prevention Program, 2007). Monitor for tachycardia, tremors.
    5) CORTICOSTEROIDS
    a) Consider systemic corticosteroids in patients with significant bronchospasm. PREDNISONE: ADULT: 40 to 80 milligrams/day in 1 or 2 divided doses. CHILD: 1 to 2 milligrams/kilogram/day (maximum 60 mg) in 1 or 2 divided doses (National Heart,Lung,and Blood Institute, 2007).

Inhalation Exposure

    6.7.1) DECONTAMINATION
    A) Move patient from the toxic environment to fresh air. Monitor for respiratory distress. If cough or difficulty in breathing develops, evaluate for hypoxia, respiratory tract irritation, bronchitis, or pneumonitis.
    B) OBSERVATION: Carefully observe patients with inhalation exposure for the development of any systemic signs or symptoms and administer symptomatic treatment as necessary.
    C) INITIAL TREATMENT: Administer 100% humidified supplemental oxygen, perform endotracheal intubation and provide assisted ventilation as required. Administer inhaled beta-2 adrenergic agonists, if bronchospasm develops. Consider systemic corticosteroids in patients with significant bronchospasm (National Heart,Lung,and Blood Institute, 2007). Exposed skin and eyes should be flushed with copious amounts of water.
    6.7.2) TREATMENT
    A) BRONCHODILATOR
    1) BRONCHOSPASM SUMMARY
    a) Administer beta2 adrenergic agonists. Consider use of inhaled ipratropium and systemic corticosteroids. Monitor peak expiratory flow rate, monitor for hypoxia and respiratory failure, and administer oxygen as necessary.
    2) ALBUTEROL/ADULT DOSE
    a) 2.5 to 5 milligrams diluted with 4 milliliters of 0.9% saline by nebulizer every 20 minutes for three doses. If incomplete response, administer 2.5 to 10 milligrams every 1 to 4 hours as needed OR administer 10 to 15 milligrams every hour by continuous nebulizer as needed. Consider adding ipratropium to the nebulized albuterol; DOSE: 0.5 milligram by nebulizer every 30 minutes for three doses then every 2 to 4 hours as needed, NOT administered as a single agent (National Heart,Lung,and Blood Institute, 2007).
    3) ALBUTEROL/PEDIATRIC DOSE
    a) 0.15 milligram/kilogram (minimum 2.5 milligrams) diluted with 4 milliliters of 0.9% saline by nebulizer every 20 minutes for three doses. If incomplete response administer 0.15 to 0.3 milligram/kilogram (maximum 10 milligrams) every 1 to 4 hours as needed OR administer 0.5 mg/kg/hr by continuous nebulizer as needed. Consider adding ipratropium to the nebulized albuterol; DOSE: 0.25 to 0.5 milligram by nebulizer every 20 minutes for three doses then every 2 to 4 hours as needed, NOT administered as a single agent (National Heart,Lung,and Blood Institute, 2007).
    4) ALBUTEROL/CAUTIONS
    a) The incidence of adverse effects of beta2-agonists may be increased in older patients, particularly those with pre-existing ischemic heart disease (National Asthma Education and Prevention Program, 2007). Monitor for tachycardia, tremors.
    5) CORTICOSTEROIDS
    a) Consider systemic corticosteroids in patients with significant bronchospasm. PREDNISONE: ADULT: 40 to 80 milligrams/day in 1 or 2 divided doses. CHILD: 1 to 2 milligrams/kilogram/day (maximum 60 mg) in 1 or 2 divided doses (National Heart,Lung,and Blood Institute, 2007).
    B) MONITORING OF PATIENT
    1) Chest x-ray and pulmonary function testing or peak flow measurement may be useful in symptomatic patients.
    C) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Eye Exposure

    6.8.1) DECONTAMINATION
    A) EYE IRRIGATION, ROUTINE: Remove contact lenses and irrigate exposed eyes with copious amounts of room temperature 0.9% saline or water for at least 15 minutes. If irritation, pain, swelling, lacrimation, or photophobia persist after 15 minutes of irrigation, an ophthalmologic examination should be performed (Peate, 2007; Naradzay & Barish, 2006).

Dermal Exposure

    6.9.1) DECONTAMINATION
    A) DERMAL DECONTAMINATION
    1) DECONTAMINATION: Remove contaminated clothing and wash exposed area thoroughly with soap and water for 10 to 15 minutes. A physician may need to examine the area if irritation or pain persists (Burgess et al, 1999).
    6.9.2) TREATMENT
    A) SKIN CARE
    1) Workers should frequently wash exposed areas with soap and water. Rubber gloves with cotton liners should be used when handling raw enzyme materials. Uniforms should be changed daily (Smith et al, 1989).
    B) CORTICOSTEROID
    1) Topical mild hydrocortisone cream may provide symptomatic relief (McMurrain, 1970).
    2) In severe cases of dermatitis oral prednisone may provide symptomatic relief (Smith et al, 1989).
    C) Treatment should include recommendations listed in the ORAL EXPOSURE section when appropriate.

Range Of Toxicity

Summary

    A) There are limited human data. Rapid emesis was the only effect seen in dogs ingesting 6 mg to 2.5 g/kg of enzyme detergents or pre-soaks.

Maximum Tolerated Exposure

    A) ROUTE OF EXPOSURE
    1) ORAL -
    a) Single oral doses of 2.5 grams/kilogram of detergents or presoaks to dogs produced prompt emesis as the only effect (Griffith, 1969). The emetic dose (ED50) of laundry products ranged from 6 to 25 milligrams/kilogram in dogs.
    2) DERMAL -
    a) Exposure to 5% aqueous solution of 1:1 enzyme-detergent mixtures produced more irritation than detergent alone in rabbits (Griffith, 1969).
    b) ACUTE SPONGIOTIC DERMATITIS - Was reported in a bakery worker after handling B. subtilis derived enzyme tablets for a prolonged period of time. Tenderness, vesiculation, and fissuring of both palms were noted. The patient was treated with oral prednisone for 3 weeks and the dermatitis resolved over 6 months. Other workers with similar problems were also reported (Smith et al, 1989).
    3) INHALATION -
    a) Guinea pigs exposed to aerosolized enzyme solution 80,000 Glycine units/cubic meter for one hour developed respiratory distress, hypothermia and intra-alveolar hemorrhage and eosinophil infiltration (Anon, 1976). Monkeys showed no biologic effects at levels of 1 milligram/cubic meter detergent dust (containing 200 micrograms/meter cubic meter enzyme).

Toxicity Information

    7.7.1) TOXICITY VALUES
    A) LD50- (ORAL)RAT:
    1) 3.7-10.3 g/kg -- Commercial enzyme, 20% aqueous solution (Griffith, 1969)
    2) 3.8-4.8 g/kg -- Laundry detergents, 40% solution
    3) 2.6-2.9 g/kg -- Presoaks, 40% solution

Pharmacology Toxicology

Pharmacologic Mechanism

    A) The enzyme hydrolyzes protein or carbohydrate bonds holding stains to fabric, producing water - soluble fragments.

Toxicologic Mechanism

    A) The enzymes release bradykinin and histamine, leading to bronchospasm. Release of "slow reacting substance" may be the cause of delayed bronchospasm. Dermatitis is due to primary irritant activity.

Physicochemical

Physical Characteristics

    A) It exists as dry powder.

Ph

    A) 7.0-9.5 (enzymatic action is optimum at approximately pH 8.8)

Molecular Weight

    A) 27,000-30,000 (pure B subtilis protease)

References

General Bibliography

    1) Anon: Biological effects of proteolytic enzyme detergents. Thorax 1976; 31:621-634.
    2) Berlin L, Hoborn J, & Falsen E: Enzyme sensitisation in consumers of enzyme-containing washing powder. Lancet 1970; 2:1153-1157.
    3) Burgess JL, Kirk M, Borron SW, et al: Emergency department hazardous materials protocol for contaminated patients. Ann Emerg Med 1999; 34(2):205-212.
    4) Caravati EM: Alkali. In: Dart RC, ed. Medical Toxicology, Lippincott Williams & Wilkins, Philadelphia, PA, 2004.
    5) Dor PJ, Agarwal MK, & Gleich MC: Detection of antibodies to proteases used in laundry detergents by the radioallergosorbent test. J Allergy Clin Immunol 1986; 78:877-886.
    6) Ducksbury CFJ & Dave VK: Contact dermatitis in home helps following the use of enzyme detergents. Br Med J 1970; 1:537-539.
    7) Flindt MLH: Pulmonary disease due to inhalation of dervatives of bacillus subtilis containing proteolytic enzyme. Lancet 1969; 1:1177-1181.
    8) Flood DFS, Blofeld RE, & Bruce CF: Lung function, atopy, specific hypersensitivity, and smoking of workers in the enzyme detergent industry over 11 years. Br J Ind Med 1985; 42:43-50.
    9) Griffith JF, Weaver JE, & Whitehouse HS: Safety evaluation of enzyme detergents. Oral and cutaneous toxicity, irritancy and skin sensitization studies. Fd Cosmet Toxicol 1969; 7:581-593.
    10) Johnson CL, Berstein IL, & Gallagher JS: Familial hypersensitivity pneumonitis induced by bacillus subtilis. Am Rev Resp Dis 1980; 122:339-348.
    11) Liss GM, Kominsky JR, & Gallaher JS: Failure of enzyme encapsulation to prevent sensitization of workers in the dry bleach industry. J Allergy Clin Immunol 1984; 73:348.
    12) McMurrain KD Jr: Dermatologic and pulmonary responses in the manufacturing of detergent enzyme products. J Occup Med 1970; 12:416-420.
    13) Mitchell CA & Gandevia B: Acute bronchiolitis following provocative inhalation of "alcalase" - a proteolytic enzyme used in the detergent industry. Med J Aust 1971; 1:1363-1367.
    14) Musk AW & Gandevia B: Loss of pulmonary elastic recoil in workers formerly exposed to proteolytic enzyme (alcalase) in the detergent industry. Br J Ind Med 1976; 33:158-165.
    15) Naradzay J & Barish RA: Approach to ophthalmologic emergencies. Med Clin North Am 2006; 90(2):305-328.
    16) National Asthma Education and Prevention Program: Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol 2007; 120(5 Suppl):S94-S138.
    17) National Heart,Lung,and Blood Institute: Expert panel report 3: guidelines for the diagnosis and management of asthma. National Heart,Lung,and Blood Institute. Bethesda, MD. 2007. Available from URL: http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf.
    18) Peate WF: Work-related eye injuries and illnesses. Am Fam Physician 2007; 75(7):1017-1022.
    19) Pepys J, Mitchell J, & Hawkins R: A longitudinal study of possible allergy to enzyme detergents. Clin Allergy 1985; 15:101-115.
    20) Smith DJ, Mathias CGT, & Greenwald DI: Contact dermatitis from B. subtilis-derived protease enzymes. Contact Dermatitis 1989; 20:58-59.