Newill C A, Prenger V L, Fish J E, Evans R, Diamond E L, Wei Q, Eggleston P A
Department of Immunology and Infectious Diseases, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Maryland.
Am Rev Respir Dis. 1992 Dec;146(6):1494-500. doi: 10.1164/ajrccm/146.6.1494.
As a first step in a prospective study of the incidence of asthma to laboratory animals, a group of 364 adults 18 to 48 yr of age who were beginning employment with laboratory animals were evaluated in terms of their past history, health status, allergy, and airway responsiveness to methacholine. At entry to the study, 269 had previous occupational contact with animals, 109 had chest symptoms in the previous year, 168 had a history of allergic symptoms to laboratory animals (any with asthmatic responses were systematically excluded), and 118 had positive immediate skin tests (29 had positive skin tests to laboratory animals). When defined as a PD20FEV1 of 80 breath units or less, 18.4% of these young adults had methacholine hyperresponsiveness (HRA). Significant risk factors for HRA were found to be younger age, female sex, lower educational level, a history of allergic symptoms to laboratory animals, and a history of chest symptoms. Positive skin tests to laboratory animals were present in 8% of workers; this was not a significant risk factor for HRA although positive skin tests to pollen and household allergens were. Previous work experience was a risk factor, especially among those with allergic symptoms, and a trend toward self-selection was suggested in that the rate of HRA was lowest in workers with more than 2 yr of experience or with two or more previous jobs with laboratory animals.
作为对实验动物哮喘发病率进行前瞻性研究的第一步,对一组364名年龄在18至48岁开始从事实验动物相关工作的成年人,就其既往史、健康状况、过敏情况以及对乙酰甲胆碱的气道反应性进行了评估。在研究开始时,269人有过动物接触职业史,109人在前一年有胸部症状,168人有对实验动物过敏症状史(有哮喘反应者均被系统排除),118人皮肤试验即刻反应阳性(29人对实验动物皮肤试验阳性)。当将PD20FEV1定义为80呼吸单位及以下时,这些年轻成年人中有18.4%存在乙酰甲胆碱高反应性(HRA)。发现HRA的显著危险因素为年龄较小、女性、教育水平较低、有对实验动物过敏症状史以及有胸部症状史。8%的工作人员对实验动物皮肤试验阳性;这不是HRA的显著危险因素,尽管对花粉和家庭过敏原皮肤试验阳性是。既往工作经历是一个危险因素,尤其是在有过敏症状者中,并且提示存在自我选择倾向,因为在有超过2年工作经验或有两份或更多份之前在实验动物相关岗位工作经历的工作人员中,HRA发生率最低。