Gautrin D, Ghezzo H, Infante-Rivard C, Malo J L
Department of Chest Medicine, Hôpital du Sacré-Coeur, Montreal.
Am J Respir Crit Care Med. 2000 Oct;162(4 Pt 1):1222-8. doi: 10.1164/ajrccm.162.4.2001023.
We investigated prospectively the incidence and determinants of work-related specific skin sensitization in a cohort of 769 apprentices, including 417 in animal health technology, 230 in pastry-making, and 122 in dental-hygiene technology. Subjects were recruited when starting exposure to laboratory animals, flour, or latex. A questionnaire and skin-prick tests with common and work-related allergens were administered on entry and at follow-up visits from 8 to 44 mo; information on number of hours of exposure to specific allergens was obtained. Among 769 apprentices, 698 attended >/= 1 follow-up visit. A total of 111 subjects developed specific sensitization over the study period. The incidence of work-related sensitization (per person-year) was 8.9% (95% CI 7.3 to 11.0%) in the animal-health program, 4.2% (95% CI 1.8 to 8.2%) in the pastry-making program, and 2.5% (95% CI = 0.7 to 4.3%) in the dental-hygiene program. In the animal health group, Cox regression analyses showed that atopy, nasal, and respiratory symptoms in the pollen season, and exposure assessed by the school attended or by duration of exposure to rodents were the most significant predictors of sensitization. In the dental-hygiene program, atopy and asthma were significant determinants. This study shows that: (1) an apprenticeship in animal-health technology carries a greater risk of developing specific sensitization than do apprenticeships in pastry-making and dental-hygiene; (2) atopy, respiratory symptoms in the pollen season, and number of hours in contact with rodents determine the risk of sensitization in apprentices in the animal health program.
我们对769名学徒进行了一项前瞻性研究,以调查与工作相关的特定皮肤致敏的发生率及其决定因素。这些学徒包括417名动物健康技术专业、230名糕点制作专业和122名牙齿卫生技术专业的学生。受试者在开始接触实验动物、面粉或乳胶时被招募。在入职时以及随访8至44个月期间,进行了问卷调查以及针对常见和与工作相关的过敏原的皮肤点刺试验;还获取了关于接触特定过敏原的小时数的信息。769名学徒中,698人参加了≥1次随访。在研究期间,共有111名受试者出现了特定致敏。动物健康项目中与工作相关的致敏发生率(每人年)为8.9%(95%可信区间7.3%至11.0%),糕点制作项目中为4.2%(95%可信区间1.8%至8.2%),牙齿卫生项目中为2.5%(95%可信区间0.7%至4.3%)。在动物健康组中,Cox回归分析表明,特应性、花粉季节的鼻部和呼吸道症状,以及通过就读学校或接触啮齿动物的持续时间评估的接触情况是致敏的最显著预测因素。在牙齿卫生项目中,特应性和哮喘是显著的决定因素。本研究表明:(1)动物健康技术专业的学徒比糕点制作和牙齿卫生专业的学徒发生特定致敏的风险更高;(2)特应性、花粉季节的呼吸道症状以及与啮齿动物接触的小时数决定了动物健康项目中学徒的致敏风险。