Allergenic exposure, IgE-mediated sensitization, and related symptoms in lawn cutters.

AIMS

The aims of the study conducted on lawn cutters were: (1) to evaluate exposure to pollens and molds; and (2) to assess the prevalence rate of IgE sensitization and symptoms in relation to exposure to pollens and molds.

METHODS

Environmental assessment was done with the use of personal samplers on eight workers. Our population consisted of 181 municipal park workers, including 128 lawn cutters and 67 control subjects (blue-collar workers in the hospital). A questionnaire was administered, as well as skin prick tests with seven common inhalants including pollens and eight grass molds. The main outcome variables were grass or mold sensitization (at least one of eight molds) and work-related rhinitis, conjunctivitis, and rhinoconjunctivitis. Atopy and exposure to park-related allergens, as well as sensitization to grass pollens, were considered as explanatory factors. Smoking was taken into consideration as a covariant. Both presence and duration of occupational exposure to park-related allergens were considered as parameters of exposure. Duration of exposure (months x years of exposure as lawn cutters) was used as a continuous or as a categorical variable.

RESULTS

Environmental monitoring showed that the concentration of pollens and molds decreased in magnitude from samples collected close to lawn cutters faces, short distance away in parks, and in the general environment. There was no difference in the prevalence rates for atopy between lawn cutters (32%) and control subjects (37%). Sensitization rates to grass pollen were also similar in lawn cutters (18%) and in control subjects (22%). However, there was a tendency for prevalence rates of sensitization to molds to be greater among lawn cutters (12% to Alternaria) compared with control subjects (5%). In the logistic model atopy was significantly related to grass sensitization (odds ratio [OR] = 7.2), mold sensitization (OR = 9.3), and sensitization to Alternaria (OR = 5.8). Grass sensitization was a significant risk factor for park-related rhinitis (OR = 5.8), conjunctivitis (OR = 5.0), and rhinoconjunctivitis (OR = 9.4). Exposure for 12 years or more was associated with rhinoconjunctivitis with an OR of 4.1 (95% confidence interval, 1.0-16.7). Smoking was not significantly related to any outcome.

CONCLUSION

We conclude that among lawn cutters exposure to pollens and molds is higher than in the general population, atopy is the main determinant of sensitization to these aeroallergens, and sensitization and, to a much lesser extent, exposure to grass are determinants of symptoms.