哮喘联盟

   摘要
   目的：明确香料工厂工人中过敏性呼吸道疾病的患病率和危险因素。
   方法：该项交叉-横断面研究对150例工人进行了欧共体呼吸系统健康调查问卷、以及吸入过敏筛选试验、血清特异性IgE（大蒜、辣椒粉）、肺量测定和呼出气体一氧化氮浓度(FeNO)检测。收集8小时工作制下的个人空气样本(n=62)用于分析吸入颗粒质量。采用新免疫学分析法定量测定空气中散播的大蒜和辣椒粉过敏原浓度。
   结果：空气混合物中的平均颗粒质量以粉尘(几何平均数(GM)=2.06 mg/m3 ）、辣椒粉(GM=0.44 µg/m3)和大蒜过敏原(GM=0.24 µg/m3)最高，且三者具有高度相关性。工人平均年龄33岁，71%为男性，46%为当前吸烟者、45%具有特异性疾病。香料-粉尘相关的哮喘样症状常见(17%)十分普遍，大蒜致敏占19%，其中13%为单一致敏，6%为与辣椒粉共同致敏。气流可逆性和FeNO>50 ppb的工人分别占4%和8%。大蒜颗粒高暴露量 (>0.235 µg/m3)的工人更易出现香料-粉尘相关的眼-鼻症状(OR 2.40, CI 1.09～5.27)和哮喘样症状(OR 4.15, CI 1.09～15.72)。暴露于更高浓度的辣椒粉中（(>0.92 µg/m3）(OR 11.52, CI 1.17～113.11) 较暴露于更高浓度的大蒜过敏原中更易发生大蒜单一致敏反应。因此，与大蒜致敏相比，哮喘发作很可能也与辣椒粉致敏有着更强的相关性。
   结论：暴露于含有大蒜(GM>0.24µg/m3)和辣椒粉(GM >0.44 µg/m3)过敏原的可吸入香料粉尘(GM >2.06 mg/m3)中，会增加过敏性呼吸道疾病和哮喘的发病风险。

(林江涛 审校)
Occup Environ Med. 2013 Mar 14. [Epub ahead of print]

Work-related allergic respiratory disease and asthma in spice mill workers is associated with inhalant chili pepper and garlic exposures.

van der Walt A, Singh T, Baatjies R, Lopata AL, Jeebhay MF.

Source
Faculty of Health Sciences, Centre for Occupational and Environmental Health Research, School of Public Health and Family Medicine, University of Cape Town, , Cape Town, South Africa.

Abstract
OBJECTIVE:The aim of the study was to determine the prevalence and risk factors for allergic respiratory disease in spice mill workers.
METHODS:A cross-sectional study of 150 workers used European Community Respiratory Health Survey questionnaires, Phadiatop, serum specific IgE (garlic, chili pepper), spirometry and fractional exhaled nitric oxide (FeNO). Personal air samples (n=62) collected from eight-hour shifts were analysed for inhalable particulate mass. Novel immunological assays quantified airborne garlic and chili pepper allergen concentrations.
RESULTS:Mean dust particulate mass (geometric mean (GM)=2.06 mg/m3), chili pepper (GM=0.44 µg/m3) and garlic allergen (GM=0.24 µg/m3) were highest in blending and were highly correlated. Workers' mean age was 33 years, 71% were men, 46% current smokers and 45% atopic. Spice-dust-related asthma-like symptoms (17%) were common, as was garlic sensitisation (19%), with 13% being monosensitised and 6% cosensitised to chili pepper. Airflow reversibility and FeNO>50 ppb was present in 4% and 8% of workers respectively. Spice-dust-related ocular-nasal (OR 2.40, CI 1.09 to 5.27) and asthma-like (OR 4.15, CI 1.09 to 15.72) symptoms were strongly associated with airborne garlic in the highly exposed (>0.235 µg/m3) workers. Workers monosensitised to garlic were more likely to be exposed to higher airborne chili pepper (>0.92 µg/m3) (OR 11.52, CI 1.17 to 113.11) than garlic allergens (OR 5.08, CI 1.17 to 22.08) in this mill. Probable asthma was also more strongly associated with chili pepper than with garlic sensitisation.
CONCLUSIONS:Exposure to inhalable spice dust (GM >2.06 mg/m3) containing garlic (GM>0.24 µg/m³) and chili pepper (GM >0.44 µg/m3) allergens increase the risk of allergic respiratory disease and asthma.
 

Occup Environ Med. 2013 Mar 14. [Epub ahead of print]