Schwaiblmair M, Vogelmeier C, Fruhmann G
Abteilung für Pneumologie, Klinikum Grosshadern, University of Munich, Germany.
Int Arch Occup Environ Health. 1997;70(6):419-23. doi: 10.1007/s004200050239.
To analyze the extent to which the clinical diagnosis of bleach-induced asthma can be confirmed by laboratory tests and to determine the role of work-related exposure to bleaching powder in a group of hairdressers with respiratory complaints.
The study population consisted of 55 female hairdressers who had regular contact with various hair products and a clinical history of job-related rhinitic and/or asthmatic symptoms. We divided the individuals into two groups: group I, with asthmatic symptoms (n = 38), and group II, without asthmatic symptoms (control group, n = 17). All subjects underwent immunological, pulmonary-function, and nonspecific bronchial provocation tests, and 46 study participants were subjected to a standardized bleaching-powder test in a designated chamber.
There were 13 positive responses to bleaching powder in the skin test, and 32 individuals showed positive bronchial responsiveness to acetylcholine; positive responses to the challenge with bleaching powder occurred in 9 women (22% of those tested). None of the women in group II reacted to bleaching powder. There was no significant difference between persons with a positive or a negative bronchial provocation test with regard to the evaluated parameters.
In the diagnostic workup of hairdressers with work-related respiratory symptoms, bleaching powder is one of the products that need to be tested. As not every patient with an asthmatic response to bleaching powder shows a positive response to the acetylcholine challenge test, in doubtful cases a specific exposure test may be recommendable.
分析实验室检查对漂白剂诱发哮喘临床诊断的确诊程度,并确定在一组有呼吸道症状的美发师中与工作相关的漂白粉接触的作用。
研究人群包括55名经常接触各种美发产品且有与工作相关的鼻炎和/或哮喘症状临床病史的女性美发师。我们将这些个体分为两组:第一组,有哮喘症状(n = 38);第二组,无哮喘症状(对照组,n = 17)。所有受试者均接受免疫、肺功能和非特异性支气管激发试验,46名研究参与者在指定的试验舱内接受标准化的漂白粉试验。
皮肤试验中对漂白粉有13例阳性反应,32人对乙酰胆碱表现出支气管反应阳性;9名女性(占受试人数的22%)对漂白粉激发试验有阳性反应。第二组中没有女性对漂白粉有反应。支气管激发试验阳性或阴性的人在评估参数方面没有显著差异。
在对有与工作相关呼吸道症状的美发师进行诊断检查时,漂白粉是需要检测的产品之一。由于并非每个对漂白粉有哮喘反应的患者对乙酰胆碱激发试验都呈阳性反应,在可疑病例中,推荐进行特定的接触试验。