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动物健康学徒中职业性鼻结膜炎的发病率及危险因素

Incidence of occupational rhinoconjunctivitis and risk factors in animal-health apprentices.

作者信息

Rodier François, Gautrin Denyse, Ghezzo Heberto, Malo Jean-Luc

机构信息

University of Montreal, Hôpital du Sacré-Coeur, Canada.

出版信息

J Allergy Clin Immunol. 2003 Dec;112(6):1105-11. doi: 10.1016/j.jaci.2003.08.011.

Abstract

BACKGROUND

Exposure to laboratory animals often causes the appearance of immunologic sensitization and symptoms.

OBJECTIVE

Our aim was to determine the incidence of occupational rhinoconjunctivitis and the timing of symptoms and their determinants in apprentices starting exposure to laboratory animals.

METHODS

Data from 387 (92.8%) of 417 students entering career programs in animal health in 5 schools were kept for analysis. Questionnaires and skin prick tests with common and occupational inhalants were carried out on entry and at follow-up visits scheduled at 8, 20, 32, and 44 months, depending on the schools. Responsiveness to inhaled methacholine was assessed at entry.

RESULTS

Ninety-three (24%) subjects showed incident occupational rhinoconjunctivitis symptoms, and 37 (9.6%) had symptoms combined with skin sensitization to an animal-derived allergen. Symptoms such as sneezing, rhinorrhea, and itchy eyes tended to develop early in the course of exposure. In two thirds of the subjects, symptoms persisted at subsequent visits. In a multivariate analysis the determinants of the appearance of rhinoconjunctivitis with or without allergic sensitization included sensitization to grass pollens (odds ratio [OR], 1.78; 95% CI, 0.99-3.19), as well as nasal (rhinorrhea in contact with dust: OR, 1.79; 95% CI, 1.05-3.05) and bronchial symptoms (chest tightness: OR, 3.31; 95% CI, 0.98-11.25; cough on exposure to strong odors: OR, 1.88; 95% CI, 0.98-3.59).

CONCLUSION

The incidence of occupational rhinoconjunctivitis symptoms with or without immunologic sensitization is high in apprentices starting exposure to laboratory animals. Symptoms related to histamine release are common in the early course of exposure. Determinants include immunologic and target-organ susceptibility.

摘要

背景

接触实验动物常常会导致免疫致敏和症状的出现。

目的

我们的目的是确定职业性鼻结膜炎的发病率、症状出现的时间及其在开始接触实验动物的学徒中的决定因素。

方法

保留了5所学校417名进入动物健康职业项目的学生中387名(92.8%)的数据用于分析。根据学校安排,在入学时以及8、20、32和44个月的随访时进行问卷调查和使用常见及职业性吸入变应原的皮肤点刺试验。在入学时评估对吸入乙酰甲胆碱的反应性。

结果

93名(24%)受试者出现了职业性鼻结膜炎症状,37名(9.6%)有症状并伴有对动物源性变应原的皮肤致敏。打喷嚏、流涕和眼睛瘙痒等症状往往在接触过程早期出现。三分之二的受试者在随后的随访中症状持续存在。在多变量分析中,有或无过敏致敏的鼻结膜炎出现的决定因素包括对草花粉的致敏(比值比[OR],1.78;95%可信区间[CI],0.99 - 3.19),以及鼻部症状(接触灰尘时流涕:OR,1.79;95% CI,1.05 - 3.05)和支气管症状(胸闷:OR,3.31;95% CI,0.98 - 11.25;接触强烈气味时咳嗽:OR,1.88;95% CI,0.98 - 3.59)。

结论

开始接触实验动物的学徒中,有或无免疫致敏的职业性鼻结膜炎症状发病率很高。与组胺释放相关的症状在接触早期很常见。决定因素包括免疫和靶器官易感性。

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