Prevalence of hands skin abnormalities and latex-specific IgE antibodies in workers using rubber gloves

近年来，天然橡胶乳胶已成为一个重要的职业健康问题，特别是在卫生保健工作者中，而关于其他经常戴乳胶手套的职业工人的报告一直很少见。为此，我们对某电子元器件厂工人因橡胶(乳胶)手套引起的手部皮肤异常进行了检查，共965名男性和50名女性参加了年度健康检查。手部皮肤异常的信息通过自行记录的问卷和医生的观察获得。用放射过敏吸附试验(RAST)(Pharmacia)检测胶乳特异性IgE抗体，736例橡胶手套使用者中16例(2.2%)阳性，210例非橡胶手套使用者中7例(3.3%)阳性，两组阳性率差异无统计学意义。然而，在橡胶手套使用者中，每一类别中都有一人观察到较高水平的抗体(3类和4类)。在回答问卷的718名橡胶手套使用者中，有184人(25.6%)出现了记录到的手的主观症状。在病史中，有主观症状的184人中，特应性皮炎的比例(12.5%)明显高于无主观症状的534人中的5.2%(p=0.002)。瘙痒是最常见的主观症状(59.8%)，其次是鳞片(45.7%)。不同工种的患病率不同(p=0.070)，制造业51.2%(经常使用橡胶手套)，技术类34.8%，其他27.3%。在健康检查时，没有受试者的手有任何异常。这些结果表明，几乎异常的(记录的主观症状)是除乳胶过敏外的任何其他接触性皮炎。

Natural rubber latex has become an important occupational health concern in recent years, particularly among health care workers, whereas the reports on the other occupational workers who routinely wear latex gloves have been rare. Therefore we examined hands skin abnormalities caused by rubber (latex) gloves among workers in an electronic-parts factory.The total subjects were 965 male and 50 female workers who participated in an annual health check-up. The information about hands skin abnormalities were obtained by a self-recorded questionnaire as well as by a doctor's observation. Latex-specific IgE antibody was assayed by radio allergo sorbent test (RAST) (Pharmacia).RAST was positive in 16 (2.2%) of 736 rubber-gloves-users and 7(3.3%) of 210 non-users, and the difference in the positive rates between the two groups was not statistically significant. The higher levels of the antibody (class 3 and 4), however, were observed by one in each class in the rubber-gloves-users. Recorded subjective symptoms in hands were seen in 184(25.6%) of 718 rubber-gloves-users who answered the questionnaire. In medical histories atopic dermatitis was seen in significantly higher proportion (12.5%) in the 184 subjects with subjective symptoms comparing with 5.2% in 534 subjects with no subjective symptoms (p=0.002). Itching was the most frequent subjective symptom (59.8%) and scale was the next (45.7%). Scale symptom rates tended to be differ in types of job (p=0.070) ; 51.2% in manufacture (rubber gloves are regularly used), 34.8% in technique, 27.3% in others. There was no subjects who had any abnormalities in hands at the time of the health check-up.These results suggests that the almost abnormalities (recorded subjective symptoms) were any other contact dermatitis than latex allergies.