Vedal S, Enarson D A, Chan H, Ochnio J, Tse K S, Chan-Yeung M
Department of Medicine, Vancouver General Hospital, University of British Columbia, Canada.
Am Rev Respir Dis. 1988 Mar;137(3):651-5. doi: 10.1164/ajrccm/137.3.651.
Two hundred twenty-seven workers in a western red cedar sawmill underwent methacholine bronchoprovocation testing at least 2 times during 3 surveys over a 2-yr period. At the first survey, workers completed a respiratory and occupational questionnaire, performed spirometry, gave serum for measurement of plicatic acid-specific IgE antibodies by radioallergosorbent testing, and had skin prick tests to detect atopy. Bronchial hyperresponsiveness was present initially in 18% of the workers. Approximately 15% of those with initially no hyperresponsiveness developed hyperresponsiveness during the follow-up period; 15% of those with initial hyperresponsiveness also lost it during follow-up. Development of hyperresponsiveness tended to coincide with a decrease in level of pulmonary function, whereas loss of hyperresponsiveness was associated with improvement in pulmonary function. Workers with either persistent bronchial hyperresponsiveness or with varying responsiveness had a higher prevalence of plicatic acid IgE antibodies and lower levels of initial pulmonary function than did workers with persistent nonresponsiveness. Workers with persistent hyperresponsiveness had higher initial estimated total airborne dust exposure than did other workers. Age, duration of sawmill employment, atopy, race, and cigarette smoking did not influence the occurrence of hyperresponsiveness. Levels of plicatic-acid-specific IgE antibodies did not change substantially over the 2 yr. These results indicate that immunologic sensitivity to plicatic acid and change in airway caliber are associated with the occurrence of bronchial hyperresponsiveness in cedar workers.
在两年时间内的3次调查中，一家西部红雪松锯木厂的227名工人至少接受了2次乙酰甲胆碱支气管激发试验。在第一次调查时，工人们完成了一份呼吸和职业调查问卷，进行了肺活量测定，提供血清通过放射变应原吸附试验测量对扁柏酸特异性IgE抗体，并进行皮肤点刺试验以检测特应性。最初18%的工人存在支气管高反应性。大约15%最初无高反应性的工人在随访期间出现了高反应性；15%最初有高反应性的工人在随访期间也失去了高反应性。高反应性的出现往往与肺功能水平下降同时发生，而高反应性的丧失与肺功能改善相关。与持续无反应性的工人相比，持续存在支气管高反应性或反应性变化的工人扁柏酸IgE抗体患病率更高，初始肺功能水平更低。持续高反应性的工人初始估计的总空气传播粉尘暴露量高于其他工人。年龄、锯木厂工作时长、特应性、种族和吸烟均不影响高反应性的发生。在这两年中，扁柏酸特异性IgE抗体水平没有实质性变化。这些结果表明，对扁柏酸的免疫敏感性和气道管径变化与雪松工人支气管高反应性的发生有关。
