Risk factors for sensitisation and respiratory symptoms among workers exposed to acid anhydrides: a cohort study.

Risk factors for sensitisation and respiratory symptoms among workers exposed to acid anhydrides: a cohort study.
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接触酸酐的工人致敏和呼吸道症状的危险因素:一项队列研究。

DOI:
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发表时间:
1998
影响因子:
4.9
通讯作者:
A. J. Taylor
A. J. Taylor
中科院分区:
医学2区
文献类型:
--
作者:
R. Barker;M. Tongeren;Jessica M Harris;K. Gardiner;K. Venables;A. J. Taylor

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目的:检查暴露于酸酐与对酸酐人血清白蛋白(AA-HSA)结合物产生即时皮肤点刺试验反应或工作相关呼吸道症状的风险之间的关系;评估这些关系是否因过敏症或吸烟而改变。方法:一个队列的506名工人接触邻苯二甲酸(PA),马来酸(MA),偏苯三酸酐(TMA)的定义。工人们完成了与就业史、呼吸道症状和吸烟习惯有关的问卷调查。用AA-HSA结合物和常见的吸入性过敏原进行皮肤点刺试验。在调查时测量了酸酐的暴露量,并进行了回顾性暴露评估。结果:从401名(79%)工人中获得信息。34名(8.8%)在使用酸酐工作时首次出现新的工作相关呼吸道症状,12名(3.2%)过敏,对AA-HSA结合物立即出现皮肤点刺试验反应。对酸酐的敏感性与工作相关的呼吸道症状和接触酸酐时吸烟有关。当纳入所有受试者,并考虑到所有三种酸酐时,没有一致的证据表明存在暴露-反应关系,但分析仅限于仅使用TMA的工厂,随着全轮班暴露的增加,对酸酐和工作相关呼吸道症状的敏感性增加。这种关系在目前的职业接触标准40微克·米-3范围内是明显的,并且没有因吸烟或特应性反应而显著改变。结论:暴露强度和吸烟可能是酸酐致敏的危险因素。暴露也是呼吸道症状的一个危险因素。由于有证据表明,在职业暴露标准范围内,全班暴露时对TMA有致敏作用,因此应审查该标准。
OBJECTIVES: To examine the relation between exposure to acid anhydrides and the risk of developing immediate skin prick test responses to acid anhydride human serum albumin (AA-HSA) conjugates or work related respiratory symptoms; to assess whether these relations are modified by atopy or smoking. METHODS: A cohort of 506 workers exposed to phthalic (PA), maleic (MA), and trimellitic anhydride (TMA) was defined. Workers completed questionnaires relating to employment history, respiratory symptoms, and smoking habits. Skin prick tests were done with AA-HSA conjugates and common inhalant allergens. Exposure to acid anhydrides was measured at the time of the survey and a retrospective exposure assessment was done. RESULTS: Information was obtained from 401 (79%) workers. Thirty four (8.8%) had new work related respiratory symptoms that occurred for the first time while working with acid anhydrides and 12 (3.2%) were sensitised, with an immediate skin prick test reaction to AA-HSA conjugates. Sensitisation to acid anhydrides was associated with work related respiratory symptoms and with smoking at the time of exposure to acid anhydride. When all subjects were included and all three acid anhydrides were taken into account there was no consistent evidence for an exposure-response relation, but with the analysis restricted to a factory where only TMA was in use there was an increased prevalence of sensitisation to acid anhydrides and work related respiratory symptoms with increasing full shift exposure. This relation was apparent within the current occupational exposure standard of 40 micrograms.m-3 and was not modified significantly by smoking or atopy. CONCLUSIONS: Intensity of exposure and cigarette smoking may be risk factors for sensitisation to acid anhydrides. Exposure is also a risk factor for respiratory symptoms. As there was evidence for sensitisation to TMA at full shift exposures within the occupational exposure standard this standard should be reviewed.
DOI: --
发表时间: 1984
期刊: Journal of occupational medicine. : official publication of the Industrial Medical Association
影响因子: --
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发表时间: 1993
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发表时间: 1988
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影响因子: --
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