Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands.
Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
PLoS One. 2017 Dec 6;12(12):e0189097. doi: 10.1371/journal.pone.0189097. eCollection 2017.
The objective of the present longitudinal study was to investigate the effects of occupational endotoxin exposure on respiratory health and atopic sensitization in adults. Health outcomes and personal endotoxin exposure estimates were determined for 234 farmers and agricultural workers both at baseline and 5 years later. A questionnaire was used to assess respiratory symptoms, spirometry tests were performed and total and specific IgE levels were measured in serum. A twofold increase in personal endotoxin exposure was associated with less hay fever (OR 0.68, 95%CI 0.54-0.87) and grass IgE positivity (OR 0.81, 95%CI 0.68-0.97) at both time points ("persistent" versus "never"). Although not statistically significant, a consistent protective pattern was observed for an increased loss of hay fever symptoms (OR 2.19, 95%CI 0.96-4.99) and grass IgE positivity (OR 1.24, 95%CI 0.76-2.02), and for less new-onset of hay fever (OR 0.87, 95%CI 0.65-1.17), grass IgE positivity (OR 0.83, 95%CI 0.61-1.12) and atopic sensitization (OR 0.75, 95%CI 0.55-1.02). Endotoxin exposure was not associated with changes in lung function. We showed that occupational endotoxin exposure is associated with a long-term protective effect on hay fever and grass IgE positivity. Results on longitudinal changes in hay fever, atopy and grass IgE positivity in adulthood were consistent with a protective effect of endotoxin exposure, but results need to be confirmed in larger cohorts. An effect of endotoxin exposure on lung function decline was not found.
本纵向研究的目的是调查职业性内毒素暴露对成年人呼吸道健康和特应性致敏的影响。在基线和 5 年后，对 234 名农民和农业工人的健康结果和个人内毒素暴露估计进行了测定。使用问卷评估呼吸道症状，进行了肺活量测定检查，并测量了血清中的总 IgE 和特异性 IgE 水平。个人内毒素暴露增加一倍与干草热（OR 0.68，95%CI 0.54-0.87）和草 IgE 阳性（OR 0.81，95%CI 0.68-0.97）的发生率降低相关，且在两个时间点均如此（“持续”与“从不”）。尽管没有统计学意义，但观察到一个一致的保护模式，即干草热症状的增加（OR 2.19，95%CI 0.96-4.99）和草 IgE 阳性（OR 1.24，95%CI 0.76-2.02）的发生率降低，以及新发生干草热（OR 0.87，95%CI 0.65-1.17）、草 IgE 阳性（OR 0.83，95%CI 0.61-1.12）和特应性致敏（OR 0.75，95%CI 0.55-1.02）的发生率降低。内毒素暴露与肺功能变化无关。我们表明，职业性内毒素暴露与干草热和草 IgE 阳性的长期保护作用有关。成年后干草热、特应性和草 IgE 阳性的纵向变化结果与内毒素暴露的保护作用一致，但结果需要在更大的队列中得到证实。未发现内毒素暴露对肺功能下降有影响。
