Oldenburg Marcus, Latza Ute, Baur Xaver
Department of Maritime Medicine, Institute of Occupational and Maritime Medicine (ZfAM), University of Hamburg, Seewartenstrasse 10, 20459 Hamburg, Germany.
Int Arch Occup Environ Health. 2008 May;81(6):727-34. doi: 10.1007/s00420-007-0247-3. Epub 2007 Sep 25.
In various investigated populations, sensitization to cockroaches was observed in 8% of screened subjects from temperate climatic zones and in 36% of those from tropical zones. Because of the numerous hiding places and food storages aboard a ship the crews can be highly exposed to cockroaches. The aim of this study is to assess the prevalence of sensitization to cockroaches and potentially associated health risks in seafarers.
In July 2005, a total of 145 seamen sailing under the German flag were recruited from a medical surveillance program for a cross-sectional study (response 95.4%). A standardized interview and a skin prick test (SPT) with nine common inhalant allergens and a cockroach extract (Blatella germanica) were performed. In cockroach-sensitized seafarers total and cockroach-specific IgE was measured and lung function tests conducted.
In total, 39 seamen (26.9%) were cockroach-sensitized according to SPT results. Presence of cockroach sensitization in seamen from the tropical zone (37.3%) was significantly higher than in seamen from the temperate zone (21.3%) (odds ratio 2.20, 95% confidence interval 1.04-4.66). The prevalence of sensitization to any of the other nine common allergen mixtures tested was lower (between 2.1 and 12.4%). Neither current or past cockroach exposure on board nor cumulative cockroach exposure and time since last cockroach exposure were associated with cockroach sensitization. Among cockroach SPT-positive seamen, cockroach-specific IgE was detected in 52.8%. Five out of 37 (13.5%) SPT-positive seamen exhibited an obstructive ventilation pattern. The prevalence of work-related atopic symptoms was 9.0% (n = 13). These symptoms were not related to cockroach sensitization.
The high prevalence of sensitization to cockroaches among seamen in the presented study emphasizes the strong sensitization potency of these insects. Longitudinal studies and bronchial cockroach challenge tests are necessary to assess the clinical relevance of cockroach sensitization aboard a ship in more detail.
在不同的受调查人群中，温带气候区8%的筛查对象以及热带气候区36%的筛查对象对蟑螂敏感。由于船上有众多藏身之处和食物储存地，船员可能会高度暴露于蟑螂环境中。本研究的目的是评估海员对蟑螂敏感的患病率以及潜在的相关健康风险。
2005年7月，从一项医疗监测项目中招募了145名悬挂德国国旗航行的海员进行横断面研究（应答率95.4%）。进行了标准化访谈以及针对9种常见吸入性变应原和蟑螂提取物（德国小蠊）的皮肤点刺试验（SPT）。对蟑螂敏感的海员检测了总IgE和蟑螂特异性IgE，并进行了肺功能测试。
根据SPT结果，共有39名海员（26.9%）对蟑螂敏感。热带地区海员中蟑螂敏感的比例（37.3%）显著高于温带地区海员（21.3%）（优势比2.20，95%置信区间1.04 - 4.66）。对所测试的其他9种常见变应原混合物中任何一种敏感的患病率较低（2.1%至12.4%之间）。船上当前或过去的蟑螂暴露、累积蟑螂暴露以及自上次蟑螂暴露后的时间均与蟑螂敏感无关。在蟑螂SPT阳性的海员中，52.8%检测到蟑螂特异性IgE。37名SPT阳性海员中有5名（13.5%）表现出阻塞性通气模式。与工作相关的特应性症状患病率为9.0%（n = 13）。这些症状与蟑螂敏感无关。
本研究中海员对蟑螂敏感的高患病率强调了这些昆虫强大的致敏能力。需要进行纵向研究和支气管蟑螂激发试验，以更详细地评估船上蟑螂敏感的临床相关性。
