Kruize H, Post W, Heederik D, Martens B, Hollander A, van der Beek E
Department of Epidemiology and Public Health, Wageningen, The Netherlands.
Occup Environ Med. 1997 Nov;54(11):830-5. doi: 10.1136/oem.54.11.830.
To study the role of exposure, atopy, and smoking in the development of laboratory animal allergy (LAA) in a retrospective cohort study.
Between 1977 and 1993, 225 people received a pre-employment screening when they started a job at a Dutch research institute where they were going to work with laboratory animals. After active follow up 136 of them (60.4%) could be traced and were sent a questionnaire with extensive questions on allergic symptoms, smoking habits, and job history. 122 people (89.7%) sent back a completed questionnaire. Those who were accepted for a job at the institute and did not have allergic symptoms at the start of the job were selected as cohort members. After selecting people with complete data on start and end date of jobs, exposure intensity, atopy, and smoking, the cohort consisted of 99 people with an average time of follow up of 9.7 years. LAA was defined as a positive response to a set of questions in the questionnaire. The mean number of hours a week a person was exposed to laboratory animals at entry of the cohort was used as a surrogate for exposure, and was divided into four categories.
19 cohort members (19.2%) reported LAA. More people with asthmatic symptoms were found in the high exposure categories. More atopic than non-atopic people reported asthmatic symptoms (13% v 6%). The mean time until development of symptoms of LAA was about 109 months in non-atopic people (n = 9), and 45 months in atopic people (n = 10) (t test; P < 0.05). Time until development of symptoms of LAA was shorter at a higher intensity of exposure, except for those exposed for less than two hours a week. A proportional hazard regression analysis showed that exposure and atopy were significant determinants of LAA. An increased relative risk (RR) was found for non-atopic people exposed to laboratory animal allergens for more than two hours a week. Atopic people had an even higher risk when exposed to laboratory animals for more than two hours a week (RR above 7.3). Sex, smoking, and age were not risk factors. More atopic than non-atopic people were absent from work or transferred because of allergies.
This study showed that exposure and atopy are significant predictors of LAA and that the risk of developing LAA remained present for a much longer period (> 3 y) than considered before.
在一项回顾性队列研究中，探讨接触、特应性和吸烟在实验动物过敏（LAA）发生发展中的作用。
1977年至1993年间，225人在一家荷兰研究机构开始从事与实验动物相关工作时接受了入职前筛查。经过积极随访，其中136人（60.4%）能够被追踪到，并收到了一份关于过敏症状、吸烟习惯和工作经历的详细问卷。122人（89.7%）回复了完整的问卷。那些被该机构录用且入职时没有过敏症状的人被选为队列成员。在选择了工作开始和结束日期、接触强度、特应性和吸烟等数据完整的人员后，队列由99人组成，平均随访时间为9.7年。LAA被定义为对问卷中一组问题的阳性反应。队列入组时一个人每周接触实验动物的平均小时数被用作接触的替代指标，并分为四类。
19名队列成员（19.2%）报告有LAA。在高接触类别中发现有哮喘症状的人更多。特应性人群比非特应性人群报告哮喘症状的更多（13%对6%）。非特应性人群（n = 9）出现LAA症状的平均时间约为109个月，特应性人群（n = 10）为45个月（t检验；P < 0.05）。除了每周接触时间少于两小时的人外，接触强度越高，出现LAA症状的时间越短。比例风险回归分析表明，接触和特应性是LAA的重要决定因素。每周接触实验动物过敏原超过两小时的非特应性人群相对风险（RR）增加。每周接触实验动物超过两小时的特应性人群风险更高（RR高于7.3）。性别、吸烟和年龄不是风险因素。因过敏缺勤或调岗的特应性人群比非特应性人群更多。
本研究表明，接触和特应性是LAA的重要预测因素，且发生LAA的风险持续存在的时间（> 3年）比之前认为的要长得多。
