PMID- 8836651
OWN - NLM
STAT- MEDLINE
DCOM- 19961216
LR  - 20190821
IS  - 0903-1936 (Print)
IS  - 0903-1936 (Linking)
VI  - 9
IP  - 7
DP  - 1996 Jul
TI  - Disinfectant use as a risk factor for atopic sensitization and symptoms 
      consistent with asthma: an epidemiological study.
PG  - 1407-13
AB  - Exposure to some nonallergenic compounds has been shown to increase the risk of 
      atopic sensitization and asthmatic symptoms. In order to gain more insight into 
      the largely unknown aetiology of respiratory symptoms in pig farmers, we studied 
      the role of nonallergic exposure. We evaluated associations between chronic 
      respiratory symptoms, specific and total serum immunoglobulin E (IgE) levels, use 
      of disinfectants, and endotoxin exposure levels in a population of 194 Dutch pig 
      farmers. Atopic sensitization (defined as increased production of IgE to common 
      allergens) was found to occur more frequently in farmers who used disinfectants 
      containing quaternary ammonium compounds (QACs) (odds ratio (OR) 7.4; 95% 
      confidence interval (95% CI) 1.3-43.1). ORs for other disinfectants ranged 
      2.3-4.1 (NS). Atopic sensitization was not found to occur more frequently in 
      farmers with a high endotoxin exposure. The use of disinfectants was only related 
      to respiratory symptoms consistent with asthma in atopics. This is illustrated by 
      the significantly elevated ORs for farmers with IgE to common allergens (house 
      dust mite, grass pollen, birch pollen), and who used disinfectants containing 
      QACs, in the total population and in a subgroup of the total population 
      restricted according to bronchial hyperresponsiveness to histamine (symptomatics 
      with a provocation dose of histamine producing a > or = 10% decrease in forced 
      expiratory volume in one second (PC10) < or = 16 mg.mL-1, compared with 
      asymptomatics with a PC10 > 16 mg.mL-1) (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.
FAU - Preller, L
AU  - Preller L
AD  - Dept. of Epidemiology and Public Health, Wageningen Agricultural University, The 
      Netherlands.
FAU - Doekes, G
AU  - Doekes G
FAU - Heederik, D
AU  - Heederik D
FAU - Vermeulen, R
AU  - Vermeulen R
FAU - Vogelzang, P F
AU  - Vogelzang PF
FAU - Boleij, J S
AU  - Boleij JS
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur Respir J
JT  - The European respiratory journal
JID - 8803460
RN  - 0 (Allergens)
RN  - 0 (Disinfectants)
RN  - 0 (Endotoxins)
RN  - 0 (Quaternary Ammonium Compounds)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 820484N8I3 (Histamine)
SB  - IM
MH  - Adult
MH  - Agricultural Workers' Diseases/chemically induced/*epidemiology/immunology
MH  - Allergens/adverse effects
MH  - Animals
MH  - Asthma/chemically induced/*epidemiology/immunology/physiopathology
MH  - Bronchial Hyperreactivity/physiopathology
MH  - Bronchial Provocation Tests
MH  - Disinfectants/*adverse effects
MH  - Endotoxins/adverse effects
MH  - Histamine
MH  - Humans
MH  - Hypersensitivity, Immediate/chemically induced/*epidemiology/immunology
MH  - Immunoglobulin E/immunology
MH  - Male
MH  - Occupational Exposure
MH  - Quaternary Ammonium Compounds/adverse effects
MH  - Risk Factors
MH  - Swine
EDAT- 1996/07/01 00:00
MHDA- 1996/07/01 00:01
CRDT- 1996/07/01 00:00
PHST- 1996/07/01 00:00 [pubmed]
PHST- 1996/07/01 00:01 [medline]
PHST- 1996/07/01 00:00 [entrez]
AID - 10.1183/09031936.96.09071407 [doi]
PST - ppublish
SO  - Eur Respir J. 1996 Jul;9(7):1407-13. doi: 10.1183/09031936.96.09071407.