Subclinical immunologic and physiologic responses in hexamethylene diisocyanate-exposed auto body shop workers.
Subclinical immunologic and physiologic responses in hexamethylene diisocyanate-exposed auto body shop workers.
复制标题
暴露于六亚甲基二异氰酸酯的汽车车身车间工人的亚临床免疫和生理反应。
DOI：
10.1002/ajim.1058
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发表时间：
2001
影响因子：
3.5
通讯作者：
Cullen,MR
中科院分区：
文献类型：
--
作者：
Redlich,CA;Stowe,MH;Wisnewski,AV;Eisen,EA;Karol,MH;Lemus,R;Holm,CT;Chung,JS;Sparer,J;Liu,Y;Woskie,SR;Appiah-Pippim,J;Gore,R;Cullen,MR
背景二异氰酸酯是一种有效的致敏剂，目前是工业化国家职业性哮喘最常见的致病原因。然而，二异氰酸酯哮喘很难诊断，暴露和宿主风险因素尚不清楚。车身车间是最常见的六亚甲基二异氰酸酯(HDI)暴露环境之一，由于其规模小且暴露时断时续，因此尤其难以研究。对这类工人的监测研究是有限的。目的我们发起了一项横断面现场流行病学研究，耶鲁大学汽车车身喷漆工和维修工调查(SPEAM)，以表征二异氰酸酯暴露对积极就业的汽车车身车间工人的影响。方法和结果我们提供了75名参与研究的受试者的问卷调查、生理学、免疫学和暴露数据。根据肺活量测定、乙酰甲胆碱激发、峰值流量和症状，未发现临床明显的二异氰酸酯哮喘病例。在接触HDI的工人中，有30%的人存在HDI特异性淋巴细胞增殖，在34%的HDI接触者中存在HDI特异性免疫球蛋白，但它们之间没有相关性。在两名工人中检测到HDI特异性IgE。在接触HDI最严重的工人中，HDI特异的淋巴细胞增殖、乙酰甲胆碱反应性增强以及胸闷和呼吸急促的症状更常见。对这一队列进行更多的长期随访，应该能阐明这些HDI特异性免疫反应、生理变化和症状的意义。结论这些发现表明，在很大比例的健康HDI暴露工人中存在HDI特异性免疫反应。上午好。J.Ind.地中海医院。39：587-597,2001。©2001 Wiley-Liss公司
BackgroundDiisocyanates are potent sensitizing agents and currently the most commonly identified cause of occupational asthma in industrialized countries. However, diisocyanate asthma is difficult to diagnose and exposure and host risk factors are unclear. Auto body shops, one of the most common hexamethylene diisocyanate (HDI) exposure settings, are particularly difficult to study due to their small size and episodic exposures. Surveillance studies of such workers are limited.ObjectivesWe have initiated a cross‐sectional field epidemiologic study, Survey of Painters and Repairers of Auto bodies by Yale (SPRAY), to characterize the effects of diisocyanate exposures on actively employed auto body shop workers.Methods and ResultsWe present here questionnaire, physiologic, immunologic, and exposure data on 75 subjects enrolled in the study. No overt cases of clinically apparent diisocyanate asthma were identified based on spirometry, methacholine challenge, peak flows, and symptoms. HDI‐specific lymphocyte proliferation was present in 30% of HDI‐exposed workers and HDI‐specific IgG in 34% of HDI‐exposed workers, but they were not associated. HDI‐specific IgE was detected in two workers. HDI‐specific lymphocyte proliferation, increased methacholine responsiveness, and symptoms of chest tightness and shortness of breath were more common in the most heavily HDI‐exposed workers, the painters. More long‐term follow‐up of this cohort should clarify the significance of these HDI‐specific immunologic responses, physiologic changes, and symptoms.ConclusionsThese findings demonstrate the presence of HDI‐specific immune responses in a large proportion of healthy HDI‐exposed workers. Am. J. Ind. Med. 39:587–597, 2001. © 2001 Wiley‐Liss, Inc.