Lipińska-Ojrzanowska Agnieszka, Wiszniewska Marta, Świerczyńska-Machura Dominika, Wittczak Tomasz, Nowakowska-Świrta Ewa, Pałczyński Cezary, Walusiak-Skorupa Jolanta
Department of Occupational Diseases and Toxicology, Nofer Institute of Occupational Medicine, Łódź, Poland,
Int J Occup Med Environ Health. 2014 Jun;27(3):460-6. doi: 10.2478/s13382-014-0272-x. Epub 2014 May 19.
Several studies, mostly based on questionnaire-derived data, have shown an increased risk of allergic diseases, especially asthma, among cleaners. The risk factors and etiological mechanisms are still being investigated. Occupational exposure to various chemical and biological agents may induce specific sensitization and/or irritant effects. The aim of our study was to estimate the prevalence of work-related symptoms suggesting the presence of allergic disease reported by cleaners, and to relate them to the results of commercially available and standardized objective tests used for screening detection of occupational sensitization and chronic respiratory disorders.
A cross-sectional study was performed among 142 Polish workers of cleaning service in their workplaces. A detailed questionnaire, skin prick tests to common allergens and chemicals used by these workers for cleaning purposes (chloramine T, chlorhexidine, formaldehyde, glutaraldehyde, benzalconium chloride), total and specific serum IgE antibodies to disinfectants and rest spirometry were performed in all the subjects.
Fifty nine percent of all the subjects declared occurrence of at least 1 symptom suggesting allergic ailment during cleaning activities at work. Skin prick tests and specific serum IgE antibodies to disinfectants were negative in all the subjects. In 8 cases wheezing was detected during auscultation, but only in 5 of them obstructive pattern in rest spirometry was found.
Occupational allergic causation of symptoms among cleaners could be less likely than work-related symptoms associated with exacerbations of new-onset or pre-existing respiratory diseases. Therefore, in this group of workers, mainly the non-specific irritant impact of chemicals on airways should be taken into consideration.
多项研究（大多基于问卷调查得出的数据）表明，清洁人员患过敏性疾病尤其是哮喘的风险增加。风险因素和病因机制仍在研究中。职业接触各种化学和生物制剂可能会引发特定的致敏和/或刺激作用。我们研究的目的是评估清洁人员报告的提示存在过敏性疾病的工作相关症状的患病率，并将这些症状与用于筛查职业致敏和慢性呼吸系统疾病的市售标准化客观测试结果相关联。
对142名波兰清洁服务工人在其工作场所进行了一项横断面研究。对所有受试者进行了详细的问卷调查、针对常见过敏原和这些工人用于清洁目的的化学物质（氯胺T、洗必泰、甲醛、戊二醛、苯扎氯铵）的皮肤点刺试验、针对消毒剂的总血清IgE和特异性血清IgE抗体检测以及静息肺功能测定。
所有受试者中有百分之五十九宣称在工作中的清洁活动期间出现了至少1种提示过敏性疾病的症状。所有受试者的皮肤点刺试验和针对消毒剂的特异性血清IgE抗体均为阴性。听诊时在8例中检测到哮鸣音，但其中只有5例在静息肺功能测定中发现阻塞性模式。
清洁人员症状的职业性过敏病因可能比与新发或既往存在的呼吸系统疾病加重相关的工作相关症状的可能性小。因此，对于这组工人，应主要考虑化学物质对气道的非特异性刺激影响。
