Diagnostic validation of specific IgE antibody concentrations, skin prick testing, and challenge tests in chemical workers with symptoms of sensitivity to different anhydrides☆,☆☆
Section snippets
Patients
Nine consecutively investigated chemical workers who came to our outpatient department for consultation took part in this study. All of them had been occupationally exposed to dust of different anhydrides in the production of these chemicals for at least 0.7 years (Fig. 1, Table I). A trained occupational physician was responsible for physical examinations and obtaining case histories. Only symptoms that appeared repeatedly in workplaces were considered. Clinical investigations were performed
RESULTS
As shown in Table I, all but one of the nine anhydride workers complained of rhinitis and all but two complained of cough. Of the nine workers, six had both symptoms. Seven subjects reported workplace-related dyspnea, four reported excess phlegm, five reported conjunctivitis, and one reported fever.
DISCUSSION
Our results demonstrate that unconjugated free anhydrides are not suitable for diagnostic testing. This is probably due to rapid hydrolysis of these chemicals in aqueous solutions reacting to the corresponding acids. The pathologic mechanisms clinically relevant in subjects with negative IgE results and symptoms of sensitization have not been clarified. It can be assumed, however, that anhydride dust and, to a minor degree, carboxylic acids formed on hydrolysis behave as irritants in the
References (14)
- et al.
Assessment of risk factors for IgE-mediated sensitization to tetrachlorophthalic anhydride
J ALLERGY CLIN IMMUNOL
(1993) Asthma and atopy in workers with an epoxy adhesive
Br J Dis Chest
(1980)- et al.
Specificity of the human IgE response to inhaled anhydrides
J ALLERGY CLIN IMMUNOL
(1986) Reactive chemicals in industrial asthma
J ALLERGY CLIN IMMUNOL
(1991)- et al.
Double-blind, placebo-controlled immunotherapy with mixed grass-pollen allergoids. II. Comparison between parameters assessing the efficacy of immunotherapy
J ALLERGY CLIN IMMUNOL
(1988) - Baur X, Czuppon AB, Rauluk I, et al. Clinical and immunological study of 92 workers occupationally exposed to...
- et al.
A clinical and immunologic study of workers with trimellitic-anhydride-induced immunologic lung disease after transfer to low exposure jobs
Am Rev Respir Dis
(1993)
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2009, Journal of Allergy and Clinical ImmunologyCitation Excerpt :Many occupational sensitizers, particularly HMW agents (eg, flour and animal proteins), induce asthma by producing specific IgE antibodies. For some LMW agents (eg, chlorinated platinum salts, sulfonechloramide, trimellitic anhydride, and other acid anhydrides), the development of OA is accompanied by the production of specific IgE antibodies.77,78 HMW agents act as complete antigens, whereas LMW chemicals must first react with autologous or heterologous proteins to produce a functional allergen.
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2008, ChestCitation Excerpt :This process may not be applicable to all chemical sensitizers. SPT responses to anhydride-HSA conjugates were detected in 50% of anhydride-exposed workers with confirmed sensitizer-induced OA,147 and among reactive dye manufacturing workers, SPT responses to vinyl sulfone dye solutions exhibited 76% sensitivity (91% specificity) for confirmed sensitizer-induced OA.148 SPT responses to hexachloroplatinate salts have been reported in 82% of platinum refinery workers with confirmed sensitizer-induced OA.149
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From the Professional Associations’ Institute of Occupational Medicine, Institute at the Ruhr University of Bochum, Germany.
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Reprint requests: Xaver Baur, MD, PhD, BGFA, Buerkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.