Another smoking hazard: raised serum IgE concentration and increased risk of occupational allergy.

Zetterström, Olle; Österman, Karin; Machado, L.; Johansson, S. G. O.

doi:10.1136/bmj.283.6301.1215

Cited by 264 publications

(122 citation statements)

References 12 publications

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“…Atopic markers such as increased specific IgE levels and immediate skin reactivity to common inhalants seem to be even less common in smokers [20]. Smoking has however been found to be a determinant of IgE-mediated sensitization to such occupational agents as psyllium [21] and platinum salts [22]. However, smoking was not found to be associated with the development of specific skin reaction to laboratory animals in previously published studies by CULLINAN et al [2] and HEEDERIK et al [7].…”

Section: Discussioncontrasting

confidence: 37%

Host determinants for the development of allergy in apprentices exposed to laboratory animals

et al. 2001

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The aim of this study was to evaluate whether determinants of workrelated symptoms, skin sensitization and diseases differ between atopic and nonatopic subjects starting a career with exposure to laboratory animals (LA).A cohort of 417 apprentices in animal-health technology was prospectively followed during 32 or 44 months. The effect on the study outcomes of variables derived from questionnaire, skin reactivity, and lung function assessments at baseline were compared in atopic (n=212) and nonatopic (n=183) subjects.Eighty-five incident cases of sensitization to a LA-derived allergen were identified, 67 among atopic and 18 among nonatopic subjects. Baseline rhinitis symptoms in contact with pets and skin sensitization to pets were associated with the development of workrelated rhinoconjunctivitis (RC) symptoms in atopic subjects, whereas perannual rhinitis symptoms and having a PC20 (provocative concentration causing a 20% fall in forced expiratory volume in one second) ¡32 mg?mL -1 were associated in nonatopic subjects. Baseline rhinitis symptoms on contact with pets and a PC20 value ¡32 mg?mL -1 were significant determinants for developing sensitization to a specific allergen in atopic subjects only. Finally, baseline rhinitis symptoms in contact with pets and perannual rhinitis symptoms were associated with the development of occupational RC in atopic subjects, whereas in nonatopic subjects this was associated with having a PC20 value ¡32 mg?mL -1 . In conclusion, the determinants for the development of specific skin sensitization, symptoms and disease are different between atopic and nonatopic apprentices starting occupational exposure to laboratory-animal-derived allergens. Eur Respir J 2002; 19: 96-103 Exposure to laboratory animal-derived allergens carries a significant risk for immunoglobulin (Ig)-Emediated sensitization and development of oculonasal and respiratory symptoms as well as occupational rhinoconjunctivitis (RC) and asthma (OA) [1]. In a prospective assessment of 342 laboratory-animal workers, CULLINAN et al. [2] found that 46 (13%) developed skin reactivity to rat urine over a 3.5-yr period. In a prospective study of 417 apprentices starting exposure to laboratory animals and seen for a 32-to 44-month period, 85 (20%) incident cases of sensitization to at least one laboratory-animal-derived allergen were identified [3]. Interestingly, one third of these cases had probable OA as they also developed significant changes in bronchial hyperresponsiveness [4].As for most high molecular weight occupational allergens, almost all cross-sectional studies on animal workers to date [1] have shown atopy to be a risk factor for sensitization to animal-derived allergens. In a prospective assessment, the present authors found that atopy was a risk factor for skin sensitization although the relative risk (RR) was relatively low (RR=2.2, 95% confidence interval (CI)=1.2-3.9). The only other factor associated with the development of skin sensitization to animal-derived allergens was the presence of r...

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Section: Discussioncontrasting

confidence: 37%

Host determinants for the development of allergy in apprentices exposed to laboratory animals

et al. 2001

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“…Cigarette smoking also appears to increase risk of IgE-mediated occupational asthma. Workers who smoke and have been exposed to platinum salts, acid anhydrides, snow crab, green coffee beans, and ispaghula have been shown to have greater risk of developing occupational asthma than their nonsmoking coworkers (14). In contrast, for most sensitizing agents that cause asthma through mechanisms not involving specific IgE antibodies, such as diisocyanates and western red cedar, atopy and smoking do not appear to be risk factors (15,16).…”

Section: Definition/classification Of Occupational Asthmamentioning

confidence: 92%

Occupational asthma: a review.

Lombardo

Balmes

2000

Environ Health Perspect

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Occupational asthma is the most common form of occupational lung disease in the developed world at the present time. In this review, the epidemiology, pathogenesis/mechanisms, clinical presentations, management, and prevention of occupational asthma are discussed. The population attributable risk of asthma due to occupational exposures is considerable. Current understanding of the mechanisms by which many agents cause occupational asthma is limited, especially for lowmolecular-weight sensitizers and irritants. The diagnosis of occupational asthma is generally established on the basis of a suggestive history of a temporal association between exposure and the onset of symptoms and objective evidence that these symptoms are related to airflow limitation. Early diagnosis, elimination of exposure to the responsible agent, and early use of inhaled steroids may play important roles in the prevention of long-term persistence of asthma. Persistent occupational asthma is often associated with substantial disability and consequent impacts on income and quality of life. Prevention of new cases is the best approach to reducing the burden of asthma attributable to occupational exposures. Future research needs are identified.

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“…Some studies have found higher serum total IgE levels in men than in women (2, 3), but other studies did not find these differences (7)(8)(9). Several studies reported higher serum total IgE levels in smokers (6,10,11). However, it is unknown whether any sex differences in serum total IgE levels may be explained by sex differences in smoking habits.…”

mentioning

confidence: 96%

Distribution of total serum IgE and specific IgE to common aeroallergens by sex and age, and their relationship to each other in a random sample of the Dutch general population aged 20–70 years*

Kerkhof

Droste

Monchy³

et al. 1996

Allergy

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To describe the distribution of serum total IgE and specific IgE. to common aeroallergens by sex and age and to study their relationship to each other, we measured serum total IgE and specific IgE (CAP) to house-dust mite, timothy grass, cat, birch, and Cladosporium in a random sample of 2496 subjects, aged 20-70 years from the Dutch general population. We found that total IgE was higher in men, independently of smoking, and that total IgE had no relationship with age after adjustment for specific IgE and smoking in linear regression analysis. At least one positive specific IgE test was found in 32% in both sexes. Men had higher prevalences of specific IgE to house-dust mite and lower prevalences of specific IgE to birch than women. The proportion with positive specific IgE decreased with age. The mean total IgE increased with the number of positive specific IgE tests. Thus, total IgE is higher in men and has no relationship with age if specific IgE is taken into account. The prevalences of specific IgE to aeroallergens are high and decrease with increasing age. We suggest that sex differences in total IgE should be considered when using total IgE.

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Another smoking hazard: raised serum IgE concentration and increased risk of occupational allergy.

Cited by 264 publications

References 12 publications

Host determinants for the development of allergy in apprentices exposed to laboratory animals

Host determinants for the development of allergy in apprentices exposed to laboratory animals

Occupational asthma: a review.

Distribution of total serum IgE and specific IgE to common aeroallergens by sex and age, and their relationship to each other in a random sample of the Dutch general population aged 20–70 years*

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