Heederik D, Venables K M, Malmberg P, Hollander A, Karlsson A S, Renström A, Doekes G, Nieuwenhijsen M, Gordon S
Department of Environmental Sciences, Environmental and Occupational Health Group, Wageningen University and Research Center, The Netherlands.
J Allergy Clin Immunol. 1999 Apr;103(4):678-84. doi: 10.1016/s0091-6749(99)70242-3.
Recent studies in a few industries have shown that the likelihood of IgE-mediated sensitization increases with increasing exposure. The shape of the exposure-response relationships and modification by age, sex, and smoking habit has hardly been studied.
The purpose of this study was to determine exposure sensitization relationships for rat sensitization and to evaluate the influence of atopy, smoking habits, and sex.
Data from 3 cross-sectional studies in The Netherlands, the United Kingdom, and Sweden were used and involved 1062 animal laboratory workers. Selection criteria were harmonized, and this resulted in a study population of 650 animal laboratory workers (60.6% female) with less than 4 years of exposure. Air allergen levels were assessed previously and converted on the basis of an interlaboratory allergen analysis comparison. Available sera were analyzed for the presence of specific antibodies against common allergens (house dust mite, cat, dog, and grass and birch pollen) and work-related allergens (rat and mouse urinary proteins). Questionnaire items on work-related respiratory symptoms, hours worked with rats per week, job performed, smoking habits, and sex were used in this analysis
The prevalence of work-related sensitization to rat urinary allergens (IgE >0.7 KU/L) was 9.7 % (n = 63). Thirty-six of the sensitized workers had work-related symptoms (asthma or rhinitis). Two hundred forty-eight workers (38.2%) were atopic (defined as specific IgE to 1 of the common allergens). The sensitization rate increased with increasing air allergen exposure. Atopic workers exposed to low levels of allergen had a more than 3-fold increased sensitization risk compared with nonexposed atopic workers. For atopic subjects, the risk increased little with increasing exposure, whereas for nonatopic subjects, a steadily increasing risk was observed. Smoking and sex did not modify the sensitization risk.
Rat urinary allergen-sensitization risk increased with increasing exposure intensity. Workers who were atopic had a clearly elevated sensitization risk at low allergen exposure levels.
最近在一些行业开展的研究表明，IgE介导的致敏可能性会随着接触增加而升高。接触-反应关系的形式以及年龄、性别和吸烟习惯对其的影响几乎未得到研究。
本研究旨在确定大鼠致敏的接触致敏关系，并评估特应性、吸烟习惯和性别的影响。
使用了来自荷兰、英国和瑞典的3项横断面研究的数据，涉及1062名动物实验室工作人员。统一了选择标准，最终研究人群为650名动物实验室工作人员（60.6%为女性），接触时间少于4年。之前已评估了空气中变应原水平，并根据实验室间变应原分析比较进行了换算。分析现有血清中针对常见变应原（屋尘螨、猫、狗以及草和桦树花粉）和工作相关变应原（大鼠和小鼠尿蛋白）的特异性抗体。本分析使用了关于工作相关呼吸道症状、每周与大鼠接触时长、所从事工作、吸烟习惯和性别的问卷项目。
对大鼠尿变应原产生工作相关致敏（IgE>0.7 KU/L）的患病率为9.7%（n = 63）。36名致敏工人有工作相关症状（哮喘或鼻炎）。248名工人（38.2%）为特应性（定义为对1种常见变应原产生特异性IgE）。致敏率随空气中变应原接触增加而升高。与未接触变应原的特应性工人相比，接触低水平变应原的特应性工人致敏风险增加了3倍多。对于特应性受试者，风险随接触增加而增加不多，而对于非特应性受试者，观察到风险稳步增加。吸烟和性别并未改变致敏风险。
大鼠尿变应原致敏风险随接触强度增加而升高。特应性工人在低变应原接触水平下致敏风险明显升高。
