Grammer L C, Patterson R
Ann Allergy. 1987 Mar;58(3):151-9.
Occupational immunologic lung diseases either asthma or hypersensitivity pneumonitis, can occur in a wide variety of occupations from numerous antigens. New OILD syndromes and antigens are being reported constantly. In the case of some occupational agents that have been reported like isocyanates, formaldehyde, and Western red cedar, there is current investigation into the incidence of disease, mechanisms, and appropriate diagnostic criteria. A key principle in OILD is that prevention or at least early treatment by environmental control should be the goal. Determination of threshold limits for sensitization and adherence to these limits would be useful, for instance. In manufacturing processes in which this is not possible, workers and management in high risk industries should be educated so that affected workers are recognized early and avoidance can be instituted. Currently, there are no pre-employment screening criteria that have been shown to be very useful in predicting OILD. Prospective studies of animal handlers are underway and may provide useful information. In the case of TMA-exposed workers, prospective studies have demonstrated that serial immunologic studies are useful in predicting workers at risk for OILD and that reduction of airborne exposure will reduce prevalence. This sort of approach will probably be useful in studying other occupational agents. Such studies are complex and, to succeed, generally require cooperation and collaboration of physicians, industry, labor, industrial hygiene, and governmental agencies.
职业性免疫性肺部疾病，无论是哮喘还是过敏性肺炎，都可能因多种抗原出现在各种各样的职业中。新的职业性肺部疾病综合征和抗原不断被报道。对于一些已被报道的职业性致病因素，如异氰酸酯、甲醛和西部红雪松，目前正在对疾病发病率、发病机制和适当的诊断标准进行调查。职业性肺部疾病的一个关键原则是，应以预防或至少通过环境控制进行早期治疗为目标。例如，确定致敏的阈值并遵守这些限值会很有用。在无法做到这一点的制造过程中，应教育高风险行业的工人和管理人员，以便尽早识别受影响的工人并采取避免措施。目前，尚无已被证明在预测职业性肺部疾病方面非常有用的入职前筛查标准。对动物饲养员的前瞻性研究正在进行，可能会提供有用的信息。对于接触三甲胺的工人，前瞻性研究表明，系列免疫学研究有助于预测有职业性肺部疾病风险的工人，减少空气传播暴露将降低患病率。这种方法可能对研究其他职业性致病因素也有用。此类研究很复杂，要取得成功，通常需要医生、行业、劳工、工业卫生和政府机构的合作与协作。
