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暴露于高分子量制剂的学徒前瞻性队列的长期结局

Long-term outcomes in a prospective cohort of apprentices exposed to high-molecular-weight agents.

作者信息

Gautrin Denyse, Ghezzo Heberto, Infante-Rivard Claire, Magnan Michèle, L'archevêque Jocelyne, Suarthana Eva, Malo Jean-Luc

机构信息

Axe de Recherche en Santé Respiratoire, Sacré-Coeur Hospital, 5400 Gouin Blvd West, Montreal, Canada H4J 1C5.

出版信息

Am J Respir Crit Care Med. 2008 Apr 15;177(8):871-9. doi: 10.1164/rccm.200707-991OC. Epub 2008 Jan 24.

Abstract

RATIONALE

We conducted a long-term (8-yr) follow-up of 408 apprentices entering programs involving exposure to high-molecular-weight allergens.

OBJECTIVES

The objectives were to assess the frequency of new and persisting sensitization, symptoms, and bronchial hyperresponsiveness in relation with job history after ending apprenticeship and to examine characteristics significantly associated with the incidence and remission of these occupational outcomes.

METHODS

A respiratory symptom questionnaire, skin prick tests with work-related allergens (laboratory animals, flour, and latex), spirometry, and methacholine challenge were administered. The association between incidence or remission of these outcomes and individual characteristics at baseline and end of apprenticeship was examined.

MEASUREMENTS AND MAIN RESULTS

In subjects who at any time during follow-up held a job related to their training (78%), the incidence of sensitization, rhinoconjunctival and chest symptoms, and bronchial hyperresponsiveness at follow-up was 1.3, 1.7, 0.7, and 2.0 per 100 person-years, respectively. The remission of these outcomes acquired during apprenticeship was 18.5, 9.6, 9.6, and 12.4 per 100 person-years, respectively, in subjects no longer in a job related to training. Several clinical, immunological, and functional characteristics at baseline and acquired during apprenticeship were found to be significantly associated with the incidence and remission of the outcomes.

CONCLUSIONS

The incidence of sensitization, symptoms, and bronchial hyperresponsiveness was lower while at work than during the apprenticeship period. A high proportion of subjects in a job not related to training experienced remission of symptoms acquired during apprenticeship.

摘要

原理

我们对408名参加涉及接触高分子量过敏原项目的学徒进行了为期8年的长期随访。

目的

目的是评估学徒期结束后新出现和持续存在的致敏、症状及支气管高反应性的发生频率与工作经历的关系,并研究与这些职业结局的发生和缓解显著相关的特征。

方法

采用呼吸症状问卷、用与工作相关的过敏原(实验动物、面粉和乳胶)进行皮肤点刺试验、肺功能测定和乙酰甲胆碱激发试验。研究了这些结局的发生或缓解与基线和学徒期结束时个体特征之间的关联。

测量指标和主要结果

在随访期间任何时候从事与其培训相关工作的受试者(78%)中,随访时致敏、鼻结膜炎和胸部症状以及支气管高反应性的发生率分别为每100人年1.3、1.7、0.7和2.0。在不再从事与培训相关工作的受试者中,学徒期获得的这些结局的缓解率分别为每100人年18.5、9.6、9.6和12.4。发现基线时以及学徒期获得的一些临床、免疫和功能特征与这些结局的发生和缓解显著相关。

结论

工作期间致敏、症状和支气管高反应性的发生率低于学徒期。很大一部分未从事与培训相关工作的受试者在学徒期获得的症状得到缓解。

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