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Lassmann-Klee PG, Sundblad BM, Malmberg LP, Sovijärvi ARA, Piirilä P. Measurement of bronchial hyperreactivity: comparison of three Nordic dosimetric methods. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 80:222-229. [PMID: 32031428 DOI: 10.1080/00365513.2020.1719541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Clinical testing of bronchial hyperreactivity (BHR) provides valuable information in asthma diagnostics. Nevertheless, the test results depend to a great extent on the testing procedure: test substance, apparatus and protocol. In Nordic countries, three protocols predominate in the testing field: Per Malmberg, Nieminen and Sovijärvi methods. However, knowledge of their equivalence is limited. We aimed to find equivalent provocative doses (PD) to obtain similar bronchoconstrictive responses for the three protocols. We recruited 31 patients with suspected asthma and health care workers and performed BHR testing with methacholine according to Malmberg and Nieminen methods, and with histamine according to Sovijärvi. We obtained the individual response-dose slopes for each method and predicted equivalent PD values. Applying a mixed-model, we found significant differences in the mean (standard error of mean) response-dose (forced expiratory volume in one second (FEV1)%/mg): Sovijärvi 7.2 (1.5), Nieminen 13.8 (4.2) and Malmberg 26 (7.3). We found that the earlier reported cut-point values for moderate BHR and marked BHR between the Sovijärvi (PD15) and Nieminen (PD20) methods were similar, but with the Malmberg method a significant bronchoconstrictive reaction was measured with lower PD20 values. We obtained a relationship between slope values and PD (mg) between different methods, useful in epidemiological research and clinical practice.
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Affiliation(s)
- Paul G Lassmann-Klee
- Unit of Clinical Physiology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Britt-Marie Sundblad
- The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Leo P Malmberg
- Laboratory of Clinical Physiology, Skin and Allergy Hospital, Helsinki, Finland
| | - Anssi R A Sovijärvi
- Unit of Clinical Physiology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | - Päivi Piirilä
- Unit of Clinical Physiology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
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Simoneti CS, Nocera TSB, Vianna EO. Exposição prolongada a animais de laboratório está associada ao aumento de casos de asma. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2020. [DOI: 10.1590/2317-6369000036718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: descrever o resultado do acompanhamento de trabalhadores sensibilizados a animais de laboratório que prolongaram sua exposição. Métodos: após um período de aproximadamente 7 anos, entramos em contato com todos os indivíduos com sensibilização alérgica ocupacional detectada em estudo anterior. Um questionário foi aplicado para situação ocupacional atual, relação entre alergia e a decisão de deixar o trabalho ou exposição e para asma, sibilância, rinite, sintomas cutâneos e dispneia noturna. Resultados: dos 74 indivíduos com sensibilização ocupacional, 45 responderam ao questionário na segunda avaliação e 37 ainda estavam expostos. Ao comparar os dados da primeira avaliação com os da avaliação atual, observou-se um aumento na frequência de asma. Na primeira avaliação, entre todos os sensibilizados (n = 74), 27,0% responderam sim a ambas as questões “Você tem ou já teve asma?” e “A asma foi diagnosticada por um médico?”. Na segunda avaliação, 7 anos depois, dos 37 sujeitos que ainda estavam expostos, 51,3% responderam sim a essas questões (OR: 2,80; IC95%: 1,23-6,38; p = 0,013). Não houve mudança na frequência de respostas positivas às outras perguntas. Conclusão: os dados demonstram aumento da frequência de asma entre trabalhadores com sensibilização ocupacional que prolongam a exposição a animais de laboratório.
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Feary JR, Schofield SJ, Canizales J, Fitzgerald B, Potts J, Jones M, Cullinan P. Laboratory animal allergy is preventable in modern research facilities. Eur Respir J 2019; 53:13993003.00171-2019. [PMID: 30956209 DOI: 10.1183/13993003.00171-2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 03/23/2019] [Indexed: 11/05/2022]
Abstract
BACKGROUND Historical data suggest 15% of laboratory animal workers develop IgE sensitisation and 10% symptoms of laboratory animal allergy (LAA), including occupational asthma. Individually ventilated cages (IVCs) are replacing conventional open cages; we sought to evaluate their impact on the development of LAA. METHODS We surveyed 750 laboratory animal workers and measured airborne Mus m 1 (mouse allergen) levels in seven UK institutions. We compared the prevalence of sensitisation to mouse proteins (by specific IgE assay or skin prick test) and of work-related allergic symptoms in IVC-only and open cage units. RESULTS Full-shift Mus m 1 levels were lower in IVC than open cage units (geometric mean 1.00 (95% CI 0.73-1.36) versus 8.35 (95% CI 6.97-9.95) ng·m-3; p<0.001), but varied eight-fold across the IVC units (geometric mean range 0.33-4.12 ng·m-3). Primary analyses on data from 216 participants with ≤3 years exposure to mice revealed a lower prevalence of sensitisation in those working in IVC units compared with conventional cage units (2.4% (n=2) versus 9.8% (n=13); p=0.052). Sensitisation in IVC units varied from 0% to 12.5%; the use of fitted respiratory protection was less common in IVC units where prevalence of sensitisation was higher. Work-related allergy symptoms were more frequently reported by mouse-sensitised individuals (46.7% versus 10.9%; p<0.001) and only by those working in open cage units. CONCLUSION In contemporary practice, LAA is now largely preventable with the use of IVC systems and the judicious use of appropriate respiratory protection.
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Affiliation(s)
- Johanna R Feary
- Dept of Occupational Lung Disease, Royal Brompton and Harefield NHS Foundation Trust, London, UK .,Occupational and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Susan J Schofield
- Occupational and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jennifer Canizales
- Occupational and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Bernadette Fitzgerald
- Dept of Occupational Lung Disease, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - James Potts
- Occupational and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Meinir Jones
- Occupational and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Paul Cullinan
- Dept of Occupational Lung Disease, Royal Brompton and Harefield NHS Foundation Trust, London, UK.,Occupational and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
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Straumfors A, Eduard W, Andresen K, Sjaastad AK. Predictors for Increased and Reduced Rat and Mouse Allergen Exposure in Laboratory Animal Facilities. Ann Work Expo Health 2018; 62:953-965. [PMID: 29982271 PMCID: PMC6188521 DOI: 10.1093/annweh/wxy060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/06/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction Exposure to rat and mouse allergens during work in laboratory animal facilities represents a risk for being sensitized and developing allergic diseases, and it is important to keep the exposure level as low as possible. The objective of this study was to characterize the personal Mus m 1 and Rat n 1 exposure during work in laboratory animal facilities, and to investigate the effect of identified predictors of increased and reduced exposure. Methods Mus m 1 and Rat n 1 were analysed in whole day or task-based personal air samples by enhanced sensitivity sandwich enzyme-linked immunosorbent assay. Information about cage-and-rack systems, tasks, and other conditions known to influence the allergen exposure was registered. Predictors for allergen exposure were identified by multiple linear regression analyses. Results The median allergen exposure was 3.0 ng m-3 Mus m 1 and 0.5 ng m-3 Rat n 1, with large task-dependent variations among the samples. The highest exposed job group were animal technicians. Cage emptying and cage washing in the cage washroom represented the highest exposure, whereas animal experiments in the lab/operation room represented the lowest exposure, with laminar airflow bench being an exposure-reducing determinant. Cage changing was the highest exposed task in the animal room, where individually ventilated cages (IVCs) were predictors of reduced exposure for both Mus m 1 and Rat n 1, whereas cage-rack systems with open shelves and sliding doors were predictors of increased Rat n 1 exposure. Cages of IVC type with positive air pressure (IVC+) as well as open shelves and sliding doors were strong predictors of increased exposure during cage emptying and cage washing. Conclusions Significant different exposure levels depending on type of work and task imply different risks of sensitization and allergy development. The fact that IVC+ cages have opposite impact on Mus m 1 and Rat n 1 exposure during different tasks may have positive clinical implications when taken into account.
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Affiliation(s)
- Anne Straumfors
- Department of Chemical and Biological Work Environment, National Institute of Occupational Health, Majorstuen, Oslo, Norway
| | - Wijnand Eduard
- Department of Chemical and Biological Work Environment, National Institute of Occupational Health, Majorstuen, Oslo, Norway
| | - Knut Andresen
- Occupational Health Service Unit, University of Oslo, Blindern, Oslo, Norway
| | - Ann Kristin Sjaastad
- Department of HR and HSE, Norwegian University of Science and Technology, Trondheim, Norway
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Tafuro F, Selis L, Goldoni M, Stendardo M, Mozzoni P, Ridolo E, Boschetto P, Corradi M. Biomarkers of respiratory allergy in laboratory animal care workers: an observational study. Int Arch Occup Environ Health 2018; 91:735-744. [PMID: 29858653 DOI: 10.1007/s00420-018-1321-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 05/22/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Laboratory animal allergy is a highly prevalent occupational disease among exposed workers. The aim of the study was to validate the biomarkers of airway inflammation in laboratory animal (LA) care workers. METHODS All of the participants in this observational study (63 LA care workers and 64 controls) were administered a clinical questionnaire, underwent spirometry and a skin prick or radioallergosorbent test for common and occupational aeroallergens, and the fraction of exhaled nitric oxide (FeNO50), exhaled breath condensate hydrogen peroxide (EBC H2O2) and serum pneumoprotein levels were measured. Multivariate analysis (ANCOVA) was used to assess the interactions of the variables. RESULTS FeNO50 levels correlated with exposure (p = 0.002), sensitisation (p = 0.000) and age (p = 0.001), but there was no interaction between exposure and sensitisation when age was considered in the model (p = 0.146). EBC-H2O2 levels were higher in the sensitised workers than in the sensitised controls [0.14 (0.08-0.29) µM vs 0.07 (0.05-0.12) µM; p < 0.05]. Serum surfactant protein A (SP-A) levels were unaffected by exposure, sensitisation or age, although higher levels were observed in symptomatic workers; however, SP-D levels were influenced by exposure (p = 0.024) and age (p = 0.022), and club cell 16 levels were influenced by sensitisation (p = 0.027) and age (p = 0.019). CONCLUSIONS The presence of the clinical symptoms associated with LA exposure and high FeNO levels should prompt further medical assessments in LA workers. Although EBC-H2O2 levels do not seem to reflect eosinophilic inflammation, serum SP-A levels could be used to monitor progression from rhinitis to asthma.
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Affiliation(s)
- Federica Tafuro
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Luisella Selis
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Matteo Goldoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Paola Mozzoni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Erminia Ridolo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Piera Boschetto
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Massimo Corradi
- Department of Medicine and Surgery, University of Parma, Parma, Italy. .,Unit of Occupational Medicine, Department of Medicine and Surgery, University of Parma, Via Gramsci 14, 43123, Parma, Italy.
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Larese Filon F, Drusian A, Mauro M, Negro C. Laboratory animal allergy reduction from 2001 to 2016: An intervention study. Respir Med 2018; 136:71-76. [PMID: 29501249 DOI: 10.1016/j.rmed.2018.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 01/30/2018] [Accepted: 02/01/2018] [Indexed: 10/18/2022]
Abstract
Exposure to laboratory animals (LA) can cause allergic sensitization and symptoms as rhinitis, conjunctivitis, asthma, anaphylaxis and dermatitis. In 2000, a program was instituted at Trieste Universities to decrease LA allergy among scientists and technicians working with animals. The aim of our study was to investigate LA allergy in workers exposed to LA from 2001 to 2016, and to verify the effects of a preventive program. Four hundred sixty seven people underwent pre-employment screening for a job with laboratory animals at Universities of Trieste consisting in a medical examination, a full respiratory and allergy anamnesis, using a standardized questionnaire, skin prick test with common and occupational allergens, and spirometry. Every year, each worker repeated the medical examination and underwent again tests and questionnaire. Each worker can ask for a medical examination and skin prick test, in case of unset of symptoms. Logistic multivariate analysis and generalized equation estimation were use, to verify factors associated to LA allergy. Sensitization to LA decreased in years, going from 25.6% in 2001-2004 to 8.2% in 2013-2016 (p < 0.001). Multivariate logistic regression analysis confirmed the role of atopy by prick test (OR = 6; IC95% 2.2-16.6), of common allergic symptoms (OR = 2.9; IC95% 1.4-6.39) and of calendar periods. No association was found between LA allergy, years, and hours of exposure. Our study demonstrated a significant reduction of LA allergy after the application of a preventive program.
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Affiliation(s)
- Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Italy.
| | - Anna Drusian
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Italy
| | - Marcella Mauro
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Italy
| | - Corrado Negro
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Italy
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Simoneti CS, Ferraz E, de Menezes MB, Bagatin E, Arruda LK, Vianna EO. Allergic sensitization to laboratory animals is more associated with asthma, rhinitis, and skin symptoms than sensitization to common allergens. Clin Exp Allergy 2017; 47:1436-1444. [PMID: 28787776 DOI: 10.1111/cea.12994] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/21/2017] [Accepted: 07/06/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Workers exposed to laboratory animals have a high risk of developing laboratory animal allergy (LAA). Atopy seems to be the main risk factor for LAA. We hypothesized that occupational sensitization is a better predictor for the development of asthma, rhinitis, and bronchial hyperresponsiveness (BHR) than common sensitization. OBJECTIVE To investigate the association between occupational sensitization to laboratory animals and clinical outcomes. METHODS This was a cross-sectional study performed at two universities on students and employees dealing with small rodents. The subjects were allocated in groups: non-sensitized, common sensitization, or occupational sensitization, according to the results of the skin prick test (SPT). All subjects answered a questionnaire about animal exposures, symptoms, allergic diseases, and underwent spirometry and bronchial challenge test with mannitol. Multivariate analysis was performed using Poisson regression to estimate the prevalence ratio (PR). RESULTS Data from 453 volunteers were analysed. Non-sensitized group comprised 237 subjects; common sensitization group, 142 subjects; and occupational sensitization group, 74 subjects. Occupational sensitization was associated with greater risk for all outcomes studied. When the common sensitization group was reference, skin symptoms had PR of 1.36, 95% confidence interval (CI): 1.01-1.85; wheezing had PR of 1.75, CI 95%: 1.21-2.53; rhinitis had PR of 1.25, 95%: 1.11-1.40; nocturnal dyspnoea had PR of 2.40, 95% CI: 1.31-4.40; bronchial hyperresponsiveness (BHR) had PR of 2.47, 95% CI: 1.50-4.09; and confirmed asthma had PR of 2.65, 95% CI: 1.45-4.85. In addition, the overlap of asthma, rhinitis, and skin symptoms in a same subject was significantly more prevalent in the occupational sensitization group, 16.2% versus 4.9% in the common sensitization group. CONCLUSION AND CLINICAL RELEVANCE Occupational sensitization is associated with allergic symptoms and respiratory diseases. SPT with occupational allergens along with other parameters may contribute to detection of risk for allergic and respiratory diseases associated with exposure to laboratory animals.
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Affiliation(s)
- C S Simoneti
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - E Ferraz
- Regional University Center of Espírito Santo do Pinhal, Espírito Santo do Pinhal, Brazil
| | - M B de Menezes
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - E Bagatin
- Faculty of Medical Sciences, Department of Preventive and Social Medicine, State University of Campinas, Campinas, Brazil
| | - L K Arruda
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - E O Vianna
- Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Coman I, Lemière C. Fractional Exhaled Nitric Oxide (FeNO) in the Screening and Diagnosis Work-Up of Occupational Asthma. CURRENT TREATMENT OPTIONS IN ALLERGY 2017. [DOI: 10.1007/s40521-017-0122-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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