Karvala Kirsi, Nordman Henrik, Luukkonen Ritva, Nykyri Elina, Lappalainen Sanna, Hannu Timo, Toskala Elina
Occupational Medicine Team, Finnish Institute of Occupational Health, Helsinki, Finland.
Am J Rhinol. 2008 Sep-Oct;22(5):457-62. doi: 10.2500/ajr.2008.22.3209.
Numerous studies confirm the association between exposure to indoor air dampness and molds and different health outcomes. Of these, upper respiratory tract problems are the most commonly reported work-related symptoms in damp indoor environments. The aim of this study was to describe a clinically investigated patient series with occupational rhinitis induced by molds.
Nasal provocation test (NPT) with commercial fungal allergens was performed in 369 patients during 1995-2004 at the Finnish Institute of Occupational Health. Of these, 60 (16%) were positive. In addition to positive NPT, the diagnosis of occupational rhinitis was based on verified exposure to molds, work-related nasal symptoms, and clinical investigations. We wanted to review the patient files of these 60 patients retrospectively, and 56 patients gave their informed consent.
The mean age of the patients was 43.7 years (SD +/- 9.5). Fifty (89.3%) patients were women. In 23% of the patients, IgE-mediated allergy to molds could be established. Atopy significantly increased IgE sensitization to molds (OR, 10.3 [95% CI, 2.0-52.5]). The most common mold to induce occupational rhinitis was Aspergillus fumigatus. Exposure time was over 5 years in 63% of the patients. Association between the IgE sensitization to molds and exposure level was statistically significant (Fisher's exact test, p = 0.046).
This is the first clinically investigated series on occupational rhinitis in relation to a moldy environment. Based on our findings, we conclude that molds growing in conjunction with moisture damages can induce occupational rhinitis. IgE-mediated allergy to molds was not common. Atopy and significant exposure level increased IgE sensitization to molds. zri00508.
大量研究证实，接触室内空气潮湿和霉菌与不同的健康结果之间存在关联。其中，上呼吸道问题是潮湿室内环境中最常报告的与工作相关的症状。本研究的目的是描述一组经临床调查的由霉菌引起职业性鼻炎的患者系列。
1995年至2004年期间，在芬兰职业健康研究所对369名患者进行了商用真菌过敏原的鼻激发试验（NPT）。其中，60名（16%）呈阳性。除了NPT呈阳性外，职业性鼻炎的诊断还基于经证实的霉菌接触史、与工作相关的鼻部症状以及临床检查。我们想回顾这60名患者的病历，56名患者给予了知情同意。
患者的平均年龄为43.7岁（标准差±9.5）。50名（89.3%）患者为女性。23%的患者可确定为IgE介导的霉菌过敏。特应性显著增加了对霉菌的IgE致敏（比值比，10.3 [95%可信区间，2.0 - 52.5]）。诱发职业性鼻炎最常见的霉菌是烟曲霉。63%的患者接触时间超过5年。对霉菌的IgE致敏与接触水平之间的关联具有统计学意义（Fisher精确检验，p = 0.046）。
这是首个关于与发霉环境相关的职业性鼻炎的临床调查系列。基于我们的研究结果，我们得出结论，与潮湿损害共同生长的霉菌可诱发职业性鼻炎。IgE介导的霉菌过敏并不常见。特应性和显著的接触水平增加了对霉菌的IgE致敏。zri00508。
