Smoking and occupational allergy in workers in a platinum refinery.

Venables, K M; Dally, M B; Nunn, AJ; Stevens, Janelle; Stephens, Robert; Farrer, N; Hunter, Jill V.; Stewart, Marlene; Hughes, E. G.; Taylor, A J Newman

doi:10.1136/bmj.299.6705.939

Cited by 172 publications

(72 citation statements)

References 10 publications

(3 reference statements)

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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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“…Higher values of speci®c IgE or higher prevalence of subjects with positive skin tests were reported in exposed smokers when compared to nonexposed smokers [112]. These observations suggest that smoking may facilitate sensitization in exposed subjects, increasing bronchial mucosa permeability and thus facilitating and enhancing allergen penetration in the respiratory mucosa.…”

Section: Skin Prick Test: Relationship To Sex Age Ethnic Group Envmentioning

confidence: 55%

Allergy markers in respiratory epidemiology

Baldacci

Omenaas²,

Oryszczyn³

2001

Eur Respir J

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Allergy markers in respiratory epidemiology. S. Baldacci. #ERS Journals Ltd 2001. ABSTRACT: Assessing allergy by measurement of serum immunoglobulin (Ig) E antibodies is fast and safe to perform. Serum antibodies can preferably be assessed in patients with dermatitis and in those who regularly use antihistamines and other pharmacological agents that reduce skin sensitivity.Skin tests represent the easiest tool to obtain quick and reliable information for the diagnosis of respiratory allergic diseases. It is the technique more widely used, speci®c and reasonably sensitive for most applications as a marker of atopy.Measurement of serum IgE antibodies and skin-prick testing may give complimentary information and can be applied in clinical and epidemiological settings.Peripheral blood eosinophilia is less used, but is important in clinical practice to demonstrate the allergic aetiology of disease, to monitor its clinical course and to address the choice of therapy. In epidemiology, hypereosinophilia seems to re¯ect an in¯ammatory reaction in the airways, which may be linked to obstructive air¯ow limitation. Eur Respir J 2001; 17: 773±790.

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“…The highest prevalences of occupational asthma have been reported with exposures to platinum salts and proteolytic enzymes used in the detergent industry (up to 50%) (8,9). In general, however, the prevalence of occupational asthma in most cohorts of workers exposed to a known sensitizing agent is less than 10% (10).…”

Section: Definition/classification Of Occupational Asthmamentioning

confidence: 99%

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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Smoking and occupational allergy in workers in a platinum refinery.

Cited by 172 publications

References 10 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

Allergy markers in respiratory epidemiology

Occupational asthma: a review.

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