UMR6249 Chrono-Environnement, University of Franche-Comté, Besançon, France.
Parasitology-Mycology Department, University Hospital of Besançon, Besançon, France.
Int Arch Occup Environ Health. 2018 Aug;91(6):745-757. doi: 10.1007/s00420-018-1322-7. Epub 2018 May 26.
The aim of this study was to understand the differential acute effects of two distinct wheat-related dusts, such as field or stored wheat dust handling, on workers' health and how those effects evolved at 6 month intervals.
Exposure, work-related symptoms, changes in lung function, and blood samples of 81 workers handling wheat and 61 controls were collected during the high exposure season and 6 months after. Specific IgG, IgE, and precipitins against 12 fungi isolated from wheat dust were titrated by enzyme-linked immunosorbent assay, dissociation-enhanced lanthanide fluorescence immunoassay, and electrosyneresis. The level of fungi was determined in the workers' environment. Levels of exhaled fraction of nitrogen monoxide (FNO) and total IgE were obtained. Exposure response associations were investigated by mixed logistic and linear regression models.
The recent exposure to field wheat dust was associated with a higher prevalence for five of six self-reported airway symptoms and with a lower FNO than those in the control population. Exposure to stored wheat dust was only associated with cough. No acute impact of exposure on respiratory function was observed. Exposure to field wheat dust led to workers' sensitization against the three field fungi Aureobasidum, Cryptococcus, and Phoma, although exposure to storage wheat dust was associated with tolerance. The level of Ig remained stable 6 months after exposure.
The clinical picture of workers exposed to field or storage wheat dust differed. The systematic characterization of the aerosol microbial profile may help to understand the reasons for those differences.
本研究旨在了解两种不同的小麦相关粉尘（如田间或储存小麦粉尘处理）对工人健康的不同急性影响，以及这些影响在 6 个月的时间间隔内如何演变。
在高暴露季节和 6 个月后，收集了 81 名处理小麦的工人和 61 名对照工人的暴露情况、与工作相关的症状、肺功能变化和血液样本。通过酶联免疫吸附试验、解离增强镧荧光免疫测定和电泳分离法定量测定了 12 种从小麦粉尘中分离出的真菌的特异性 IgG、IgE 和沉淀素。测定了工人环境中的真菌水平。获得了呼出的一氧化氮分数（FNO）和总 IgE 的水平。通过混合逻辑回归和线性回归模型研究了暴露反应的关联。
最近接触田间小麦粉尘与六种自我报告的气道症状中的五种症状的患病率较高有关，并且 FNO 低于对照组。接触储存小麦粉尘仅与咳嗽有关。未观察到暴露对呼吸功能的急性影响。接触田间小麦粉尘导致工人对三种田间真菌（金孢子菌、隐球菌和棒孢霉）过敏，但接触储存小麦粉尘则与耐受有关。暴露后 6 个月，Ig 水平保持稳定。
暴露于田间或储存小麦粉尘的工人的临床症状不同。对气溶胶微生物特征的系统描述可能有助于了解这些差异的原因。
