Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health.
Massachusetts General Hospital, Harvard Medical School.
Ann Work Expo Health. 2017 Oct 1;61(8):1024-1028. doi: 10.1093/annweh/wxx061.
Exposure to endotoxin is known to trigger airway inflammation and symptoms, and atopy may modify the relationship between endotoxin exposure and symptom development.
To test the a priori hypothesis that atopic status modifies the relationship between endotoxin exposure and respiratory symptom development.
A prospective study of laboratory workers at The Jackson Laboratories was conducted. Allergy skin testing was performed and population demographic and clinical information was obtained at baseline. Personal exposure assessments for airborne endotoxin and surveys of self-reported symptoms were performed every 6 months. Cox proportional hazards models were used to examine the relationship between endotoxin exposure and development of mouse-associated symptoms and multivariate regression was used to test for interaction.
Overall, 16 (9%) of 174 worker-participants developed mouse-associated rhinoconjunctivitis symptoms by 24 months and 8 (5%) developed mouse-associated lower respiratory symptoms by 24 months. Among workers with endotoxin exposure above the median (≥2.4 EU m-3), 5 (6% of 80) atopics reported mouse-associated rhinoconjunctivitis symptoms at 24 months as compared to 3 (3% of 94) non-atopics. Among workers below the median endotoxin exposure (<2.4 EU m-3), 1 (1% of 80) atopic reported mouse-associated rhinoconjunctivitis symptoms at 24 months as compared to 7 (7% of 94) non-atopics. For the combination of symptoms, the adjusted hazard ratio was 6.8 (95% confidence interval: 0.7-67.2) for atopics and 0.07 (95% confidence interval: 0.01-0.5) for non-atopics.
In this occupational cohort, atopic workers may be more susceptible to, and non-atopic workers protected from, endotoxin-associated upper and lower respiratory symptoms.
已知暴露于内毒素会引发气道炎症和症状，而特应性可能会改变内毒素暴露与症状发展之间的关系。
检验特应性状态是否会改变内毒素暴露与呼吸道症状发展之间关系的先验假设。
对杰克逊实验室的实验室工作人员进行了前瞻性研究。在基线时进行了过敏皮肤测试，并获得了人群人口统计学和临床信息。每 6 个月进行一次空气中内毒素的个人暴露评估和自我报告症状调查。使用 Cox 比例风险模型来检查内毒素暴露与与老鼠相关的症状的发展之间的关系，并使用多元回归来检验交互作用。
总体而言，在 174 名工人参与者中，有 16 人（9%）在 24 个月时出现了与老鼠相关的鼻结膜炎症状，有 8 人（5%）在 24 个月时出现了与老鼠相关的下呼吸道症状。在内毒素暴露高于中位数（≥2.4 EU m-3）的工人中，有 5 名（80 名中的 6%）特应性工人在 24 个月时报告了与老鼠相关的鼻结膜炎症状，而非特应性工人为 3 名（94 名中的 3%）。在内毒素暴露低于中位数（<2.4 EU m-3）的工人中，有 1 名（80 名中的 1%）特应性工人在 24 个月时报告了与老鼠相关的鼻结膜炎症状，而非特应性工人为 7 名（94 名中的 7%）。对于组合症状，特应性工人的调整后危险比为 6.8（95%置信区间：0.7-67.2），而非特应性工人为 0.07（95%置信区间：0.01-0.5）。
在这个职业队列中，特应性工人可能更容易受到内毒素相关的上呼吸道和下呼吸道症状的影响，而非特应性工人可能会受到保护。
