Poulos Leanne Michelle, O'Meara Timothy J, Hamilton Robert G, Tovey Euan Roger
Institute of Respiratory Medicine, University of Sydney, Australia.
J Allergy Clin Immunol. 2002 Apr;109(4):701-6. doi: 10.1067/mai.2002.122463.
IgE-mediated responses to natural rubber latex allergens have become a major health problem among recognized risk groups.
The purpose of this investigation was to measure the amounts of Hevea brasiliensis latex allergen (Hev b 1) inhaled and deposited on surfaces when latex or vinyl gloves were worn and compare the results with the conventional measures (breathing zone samplers) of occupational exposure.
Hev b 1 exposure was measured by nasal sampling and breathing zone sampling. Latex allergen exposure was generated by having each subject don a pair of powdered latex examination gloves and continuing his or her normal daily activity for 30 minutes. By means of adhesive tape, surface dust samples were collected from the surfaces of gloves, the subject's hands, and work areas. Sampling was performed with subjects wearing no gloves, subjects wearing powdered vinyl gloves, subjects wearing powdered latex gloves, and nearby colleagues wearing latex gloves. All samples were assayed through use of the HALOgen assay (Inhalix, Sydney, Australia) with a Hev b 1-specific mAb. Particles transporting latex allergen were identified by a surrounding immunostain halo, and these were quantified and reported as total numbers of particles inhaled, airborne, or found on surface areas evaluated.
Study subjects inhaled 26 times more allergen when powdered latex gloves were worn than under the "no glove" and powdered vinyl glove conditions. During the same period, Hev b 1 particle levels measured in the ambient air through use of the breathing zone sampler increased by 24-fold. The median numbers of particles carrying Hev b 1 allergen per square centimeter on the surface of the hands after the wearing of latex and vinyl gloves were 1964 and 5, respectively. Latex allergen was physically associated both with cornstarch granules and with larger dust particles having a darker, more irregular appearance.
In a laboratory where gloves are worn for protection, the use of latex gloves resulted in a 26-fold increase in inhaled latex allergen over background levels measured while vinyl gloves were worn as controls. Low levels of latex exposure also occurred when vinyl gloves or no gloves were worn; the reasons for this are under investigation.
在已确认的风险人群中,免疫球蛋白E介导的对天然橡胶乳胶过敏原的反应已成为一个主要的健康问题。
本研究的目的是测量佩戴乳胶手套或乙烯基手套时吸入并沉积在表面的巴西橡胶树乳胶过敏原(Hev b 1)的量,并将结果与职业暴露的传统测量方法(呼吸区采样器)进行比较。
通过鼻腔采样和呼吸区采样测量Hev b 1暴露量。让每位受试者戴上一副有粉乳胶检查手套并持续其正常日常活动30分钟,以此产生乳胶过敏原暴露。通过胶带从手套表面、受试者手部和工作区域收集表面灰尘样本。在受试者不戴手套、戴有粉乙烯基手套、戴有粉乳胶手套以及附近戴乳胶手套的同事的情况下进行采样。所有样本均使用HALOgen检测法(Inhalix,澳大利亚悉尼)和Hev b 1特异性单克隆抗体进行检测。通过周围免疫染色光环识别携带乳胶过敏原的颗粒,并对其进行定量,报告为吸入、空气中或在所评估表面区域发现的颗粒总数。
与“不戴手套”和戴有粉乙烯基手套的情况相比,佩戴有粉乳胶手套时,研究对象吸入的过敏原多26倍。在此期间,通过呼吸区采样器在环境空气中测量的Hev b 1颗粒水平增加了24倍。佩戴乳胶手套和乙烯基手套后,每平方厘米手部表面携带Hev b 1过敏原的颗粒中位数分别为1964和5。乳胶过敏原在物理上与玉米淀粉颗粒以及外观颜色更深、更不规则的较大灰尘颗粒相关。
在一个为防护而佩戴手套的实验室中,与作为对照佩戴乙烯基手套时测量的背景水平相比,使用乳胶手套导致吸入的乳胶过敏原增加了26倍。佩戴乙烯基手套或不戴手套时也会发生低水平的乳胶暴露;其原因正在调查中。