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德国在乳胶过敏疫情爆发 10 年后的经验:乳胶过敏医护人员需采取进一步预防措施。

The German experience 10 years after the latex allergy epidemic: need for further preventive measures in healthcare employees with latex allergy.

机构信息

Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.

出版信息

Int Arch Occup Environ Health. 2010 Dec;83(8):895-903. doi: 10.1007/s00420-010-0533-3. Epub 2010 May 4.

DOI:10.1007/s00420-010-0533-3
PMID:20440508
Abstract

OBJECTIVES

Powdered latex gloves or latex gloves with high allergen content are forbidden in Germany since 1998. It was the aim of this study to test the hypothesis that nationwide preventive measures enable health care workers with latex allergy to work without health risks about 10 years afterwards.

METHODS

Ninety-one health care workers who had been reported to the accident insurance between 1996 and 2004 for occupational latex allergy were examined in 2007. The survey included a questionnaire, a physical examination, spirometry, methacholine testing, skin prick testing and serum IgE measurements to latex and environmental allergens.

RESULTS

Recent work-related possibly allergic symptoms were reported by 32 subjects (35%), among them 18 subjects (20%) with symptoms of the eyes, nose or airways. Current sensitization to latex was detected in 61 subjects (67%), and 60 subjects (66%) were atopic. Eleven subjects (12%) showed mild airway obstruction, and 27 subjects (30%) were considered hyperresponsive to methacholine. Whereas overall recent symptoms of the eyes, nose or airways were associated with current latex sensitization (OR 4.5; 95% CI 1.3-16.2), this was not the case for objective outcome parameters (spirometry, bronchial hyperresponsiveness).

CONCLUSIONS

Although most subjects had only mild disease, ongoing work-related symptoms of the eyes, nose or airways in a substantial number of subjects with latex allergy suggest the need for further secondary preventive measures in German healthcare.

摘要

目的

自 1998 年以来,德国禁止使用粉末状乳胶手套或高过敏原含量的乳胶手套。本研究旨在检验以下假设:全国范围内的预防措施使乳胶过敏的医护人员在 10 年后能够在没有健康风险的情况下工作。

方法

2007 年,对 1996 年至 2004 年期间向事故保险报告的 91 名职业性乳胶过敏的医护人员进行了检查。该调查包括问卷调查、体格检查、肺量测定、乙酰甲胆碱检测、皮肤点刺试验和乳胶及环境过敏原的血清 IgE 测量。

结果

32 名受试者(35%)报告了近期与工作相关的可能过敏症状,其中 18 名受试者(20%)有眼部、鼻部或呼吸道症状。61 名受试者(67%)检测到近期乳胶致敏,60 名受试者(66%)为特应性。11 名受试者(12%)出现轻度气道阻塞,27 名受试者(30%)对乙酰甲胆碱呈高反应性。尽管眼部、鼻部或呼吸道的近期总体症状与当前乳胶致敏相关(OR 4.5;95%CI 1.3-16.2),但客观的肺功能和支气管高反应性等结果参数并无关联。

结论

尽管大多数患者的病情仅为轻度,但相当数量的乳胶过敏患者仍存在持续的眼部、鼻部或呼吸道工作相关症状,这表明德国的医疗保健需要进一步的二级预防措施。

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