摘要
暴露于一些非致敏化合物已被证明会增加特应性致敏和哮喘症状的风险。为了进一步了解猪农呼吸道症状的病原学,我们研究了非过敏性暴露的作用。我们评估了194名荷兰养猪户群体中慢性呼吸道症状、特异性和总血清免疫球蛋白E (IgE)水平、消毒剂使用和内毒素暴露水平之间的相关性。在使用含季铵盐化合物(QACs)消毒剂的农民中,特应性敏化(定义为IgE对常见过敏原的产生增加)发生得更频繁(比值比(OR) 7.4;95%置信区间(95% CI) 1.3-43.1)。其他消毒剂的ORs范围为2.3-4.1 (NS)。在高内毒素暴露的农民中没有发现特应性致敏更频繁的发生。消毒剂的使用仅与过敏性哮喘的呼吸道症状相关。这可以从那些对常见过敏原(室内尘螨、草花粉、桦树花粉)有IgE的农民,以及使用含有QACs消毒剂的农民,显著升高的or中得到说明。根据支气管对组胺的高反应性(症状表现为组胺激发剂量产生>或1秒内用力呼气量减少10% (PC10) <或= 16 mg。与无症状患者PC10 > 16 mg.mL-1相比(OR 4.4, 95% CI 1.3-14.6; and OR 8.2, 95% CI 1.6-42.6, respectively). Atopy and use of QACs and endotoxin exposure level taken individually were not associated with respiratory symptoms. A combination of atopic sensitization and high endotoxin exposure (> 101 ng.m-3) was strongly associated with respiratory symptoms in the restricted population (OR 6.1; 95% CI 1.0-36.2). Our results suggest that occupational exposure to nonallergenic agents (disinfectants) may induce immunoglobulin E sensitization to common aeroallergens, and that the combination of atopy and exposure to nonallergenic agents (disinfectants and endotoxin) is an important risk factor for development of symptoms consistent with asthma.