Burge P S, Perks W H, O'Brien I M, Burge A, Hawkins R, Brown D, Green M
Thorax. 1979 Jun;34(3):300-7. doi: 10.1136/thx.34.3.300.
This is the final part of a study carried out to investigate occupational asthma due to sensitivity to colophony fumes (a component of soldering flux) in an electronics factory. Fifty-eight workers with occupational asthma employed on the main shop floor were investigated. In them the interval between first exposure and sensitisation varied widely with a group becoming sensitive within one to two years of first exposure, and another group whose sensitisation was delayed for three to 23 years. Once sensitised the interval between arriving at work and the onset of daily symptoms seemed to be bimodally distributed, resembling the immediate and late asthmatic symptoms seen on provocation testing. Twenty-three out of 58 had no definite daily deterioration at work but improved at the weekends. Wheeze and breathlessness occurred in the evenings at home in most, and one-third were woken by breathlessness at least on some nights. These 58 cases were compared with 48 controls without occupational asthma who had worked on the same shop floor for at least four years. Mean levels of FEV were significantly worse in the cases before exposure on Monday morning. The cases also had more than twice as much sickness absence as controls. FEV fell by more than 10% over a working shift in 33% of cases and 5% of controls. Atopy (a positive skin prick test to one or more common allergens) and a past history of allergic disease were weakly but significantly associated with being a case. The effects of smoking and a family history of allergic disease were trivial. Prick testing with an antigen derived from the colophony in the solder flux was completely negative, but cases and controls had significantly raised levels of total IgM compared with blood bank controls, perhaps suggesting some previously unrecognised immunological process.
这是一项研究的最后部分，该研究旨在调查一家电子工厂中因对松香烟雾（一种助焊剂成分）敏感而导致的职业性哮喘。对在主车间工作的58名职业性哮喘工人进行了调查。在他们当中，首次接触到致敏之间的间隔差异很大，一组在首次接触后的一到两年内就致敏了，而另一组的致敏则延迟了三到23年。一旦致敏，上班到每日症状发作之间的间隔似乎呈双峰分布，类似于激发试验中出现的速发型和迟发型哮喘症状。58人中有23人在工作时没有明确的每日病情恶化，但在周末有所改善。大多数人在家中晚上会出现喘息和呼吸急促，三分之一的人至少在某些晚上会因呼吸急促而醒来。将这58例病例与48名在同一车间工作至少四年且无职业性哮喘的对照者进行了比较。周一早晨接触前，病例组的平均第一秒用力呼气容积（FEV）水平明显更差。病例组的病假天数也比对照组多两倍以上。33%的病例在一个工作班次中FEV下降超过10%，而对照组为5%。特应性（对一种或多种常见过敏原皮肤点刺试验呈阳性）和过敏性疾病既往史与病例组呈弱但显著的相关性。吸烟和过敏性疾病家族史的影响微不足道。用助焊剂中松香衍生的抗原进行点刺试验完全为阴性，但与血库对照相比，病例组和对照组的总IgM水平均显著升高，这可能提示了一些以前未被认识的免疫过程。
