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[美发师在呼出一氧化氮(FENO)测量方面面临的职业挑战]

[Occupational challenges in hairdressers with regard to FENO measurements].

作者信息

Barbinova L, Baur X

机构信息

Ordinariat und Zentralinstitut für Arbeitsmedizin (ZfA), Universität Hamburg.

出版信息

Pneumologie. 2007 Feb;61(2):119-22. doi: 10.1055/s-2006-954973.

Abstract

A clear diagnosis of occupational asthma in hairdressers usually is difficult since standardized tests are lacking. We investigated the potential role of F (E)NO measurements for complementary diagnostic and pathophysiological assertions. Only a few of the work-related respiratory complaints of fifteen examined hairdressers were associated with a significant bronchial obstruction at rest, a non-specific hyperreactivity, a broncho-obstructive reaction in the specific provocation test and/or a type I allergy to work-related agents. In a total of 53 %, at least one of these parameters was pathological and multiple deviations were exceptional. It is remarkable that atopical subjects were underrepresented in the whole group, but represented the majority of those hairdressers who had developed the occupational disease no. 4302. The results of F (E)NO measurements performed for the first time with a group of hairdressers (we found in only 3 subjects increased baseline values, in only 1 subject increased F (E)NO after the exposure test) which diagnostically proved to be helpful to detect allergic and isocyanate asthma are also inconsistent with a substantial airway allergy due to work-related substances. On the other hand, the few atopical hairdressers show a significantly higher disease risk. Hairdressers' respiratory complaints obviously occur mainly due to chemical-irritative stimuli on the bronchial mucosa, especially in atopical subjects. In contrast to our results, by acknowledgment of an occupational disease mostly (in about 66 %) allergizing effects according to occupational disease no. 4301 are accepted.

摘要

由于缺乏标准化测试,通常很难明确诊断美发师的职业性哮喘。我们研究了呼出一氧化氮(F(E)NO)测量在辅助诊断和病理生理判断方面的潜在作用。在接受检查的15名美发师中,只有少数与工作相关的呼吸道症状与静息时显著的支气管阻塞、非特异性高反应性、特异性激发试验中的支气管阻塞反应和/或对工作相关物质的I型过敏有关。总共有53%的人至少有一项上述参数异常,多项异常的情况很少见。值得注意的是,非特应性个体在整个群体中所占比例较低,但在已患4302号职业病的美发师中占大多数。首次对一组美发师进行呼出一氧化氮(F(E)NO)测量的结果(我们发现只有3名受试者基线值升高,只有1名受试者在暴露试验后呼出一氧化氮(F(E)NO)升高)在诊断上有助于检测过敏性和异氰酸酯哮喘,但这也与因工作相关物质导致的严重气道过敏不一致。另一方面,少数非特应性美发师显示出明显更高的患病风险。美发师的呼吸道症状显然主要是由于支气管黏膜受到化学刺激性刺激引起的,尤其是在非特应性个体中。与我们的结果相反,根据4301号职业病,大多数情况下(约66%)认可过敏效应。

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