Abstract
BackgroundWe have investigated the relationship between atopic status and long-term occupational exposure to latex proteins or methyl diethyl diisocyanate (MDI) as high and low molecular weight asthma-inducing agents, respectively.MethodsThis study is based on retrospective analyses of two groups of symptomatic outpatients: 184 healthcare workers with latex exposure and 156 workers with isocyanate (MDI) exposure. We analysed atopic and non-atopic subgroups according to exposure duration and the frequencies of specific sensitization.Results45% of the healthcare subgroup specifically sensitized to latex were atopic, whereas in the non-sensitized healthcare subgroup only 26% were atopic. On the other hand, subjects specifically sensitized to MDI were rarely atopic (only 15%), whereas in the subgroup non-sensitized to MDI atopy was present in 38%. After prolonged durations of exposure, the proportion of atopics was further elevated in most healthcare subgroups but it decreased in the MDI-exposed subjects.ConclusionsWe hypothesize that latex proteins as sensitizing agents might promote the development of atopy, whereas exposure to the low molecular weight MDI might inhibit the atopic status.
Highlights
Atopy, the tendency to induce IgE responses and IgEmediated allergies to “trivial” concentrations of environmental allergens, has been defined in different ways – either from a pre-existing history of atopic disorders, increased total IgE levels or immediate-type sensitization to ubiquitous allergens, with the last definition currently favoured
All IgE-sensitized subjects were diagnosed with occupational asthma; the proportion of atopic isocyanate workers was significantly higher in the subgroup without occupational asthma than the subgroup with occupational asthma (41% vs. 26%; p < 0.05)
Possible pathomechanistic background for effects of occupational exposure to mainly irritative agents on specific sensitization As opposed to high molecular weight compounds such as latex allergens, specific IgE sensitization is not a major pathomechanism in isocyanate asthma; the nonIgE mediated form accounts for the majority of isocyanate asthma (87% in our study)
Summary
The tendency to induce IgE responses and IgEmediated allergies to “trivial” concentrations of environmental allergens, has been defined in different ways – either from a pre-existing history of atopic disorders, increased total IgE levels or immediate-type sensitization to ubiquitous allergens, with the last definition currently favoured. Atopy identified as a risk factor Cullinan et al [6] examined 342 employees working in animal laboratories and found a strong positive association between pre-existing sensitization to environmental protein allergens and the development of newly occurring work-related asthmatic symptoms. Walusiak et al [7] interpreted atopy as a confounder in the sensitization to flour allergens and Skjold et al [8] identified atopy as a risk factor for work-related asthma symptoms and rhinitis. The study of seafood handlers and caterers showed a positive association between atopy and occupational skin diseases induced by crustacea [10]. We have investigated the relationship between atopic status and long-term occupational exposure to latex proteins or methyl diethyl diisocyanate (MDI) as high and low molecular weight asthma-inducing agents, respectively
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