Douglas J D, McSharry C, Blaikie L, Morrow T, Miles S, Franklin D
Tweeddale Medical Practice, Fort William, UK.
Lancet. 1995 Sep 16;346(8977):737-40. doi: 10.1016/s0140-6736(95)91505-2.
Within 3 months of the opening of a salmon-processing plant in the UK, some workers complained of symptoms suggestive of occupational asthma. A survey of all 291 employees identified 24 (8.2%) with occupational asthma. The employees worked near machines which generated respirable aerosols containing salmon-serum proteins. The IgE response to these proteins was associated with occupational asthma (p < 0.001), with increasing severity of symptoms (p < 0.001), and with working distance from the aerosol source (p = 0.037). The main factor which predisposed to IgE-antibody production and asthma was cigarette smoking (p < 0.001), whereas atopy and a previous allergic history did not. The affected employees were reallocated to a low-exposure worksite and factory ventilation was improved. Eleven showed significant clinical and pulmonary function improvement, and continued in employment. Thirteen who still had symptoms were advised to leave, thereafter becoming symptom-free, and regaining normal respiratory function. Early recognition of symptoms and prompt action to reduce aerosol exposure avoided the long-term reduction in pulmonary functions often associated with occupational asthma.
在英国一家鲑鱼加工厂开业后的3个月内，一些工人抱怨出现了提示职业性哮喘的症状。对所有291名员工进行的一项调查发现，有24人（8.2%）患有职业性哮喘。这些员工在靠近产生含有鲑鱼血清蛋白的可吸入气雾剂的机器附近工作。对这些蛋白质的IgE反应与职业性哮喘相关（p<0.001），与症状严重程度增加相关（p<0.001），并与距气雾剂源的工作距离相关（p = 0.037）。易引发IgE抗体产生和哮喘的主要因素是吸烟（p<0.001），而特应性体质和既往过敏史则不然。受影响的员工被重新分配到低暴露工作场所，并改善了工厂通风。11人临床和肺功能有显著改善，并继续工作。13名仍有症状的员工被建议离职，此后症状消失，呼吸功能恢复正常。早期识别症状并迅速采取行动减少气雾剂暴露，避免了通常与职业性哮喘相关的肺功能长期下降。
