D. Charpin

Prevalence of latex allergy in operating room nurses

The twofold purpose of this study was to assess the prevalence of latex sensitivity in a large group of operating room nurses and to evaluate the relationship between questionnaire responses and skin tests. Of the total target population of 268 operating room nurses, 248 (93%) answered the questionnaire and 197 had skin prick tests to latex (1/10 wt/vol solution). Symptoms associated with glove wearing were acknowledged by 41.1% of nurses. Skin tests to latex were positive in 21 nurses (10.7%), 4.4 times more often in atopic nurses. Among nurses complaining of local symptoms, only 18.6% had positive skin tests. Itching of the hands during glove wearing correlated poorly with latex sensitivity, but correlation with local urticaria was better. Atopic nurses complaining of urticaria had latex allergy in 70% of cases. Thus latex allergy is common in nurses, especially atopic nurses. A questionnaire is unreliable in predicting latex sensitivity and must be supported by latex skin test. More data will be needed to assess the risk of anaphylactic perioperative reactions in operating room nurses.

Twenty five year mortality and air pollution: results from the French PAARC survey.

Aims and Methods: Long term effects of air pollution on mortality were studied in 14 284 adults who resided in 24 areas from seven French cities when enrolled in the PAARC survey (air pollution and chronic respiratory diseases) in 1974. Daily measurements of sulphur dioxide, total suspended particles, black smoke, nitrogen dioxide, and nitric oxide were made in 24 areas for three years (1974–76). Cox proportional hazards models controlling for individual confounders (smoking, educational level, body mass index, occupational exposure) were applied, and frailty models used to take into account spatial correlation. Indicators of air pollution were the mean concentration. Results: Models were run before and after exclusion of six area monitors influenced by local traffic (NO/NO2 >3 in ppb). After exclusion of these areas, analyses showed that adjusted risk ratios (95% CI) for TSP, BS, NO2, and NO for non-accidental mortality were 1.05 (1.02 to 1.08), 1.07 (1.03 to 1.10), 1.14 (1.03 to 1.25), and 1.11 (1.05 to 1.17) for 10 μg/m3 respectively. Consistent patterns for lung cancer and cardiopulmonary causes were observed. Conclusions: Urban air pollution assessed in the 1970s was associated with increased mortality over 25 years in France.

Allergic vs nonallergic asthma: what makes the difference?

Background: The aim of this work was to describe clinical similarities and differences between allergic and nonallergic asthmatics, notably concerning the nasosinusal involvement.

Long‐term exposure to background air pollution related to respiratory and allergic health in schoolchildren

Background The impact of air pollution on asthma and allergies still remains a debate.

Long-term exposure to close-proximity air pollution and asthma and allergies in urban children

The aim of this study was to evaluate the impact of urban air pollution, assessed through reliable indicators of exposure, on asthma and allergies in schoolchildren. A validated dispersion model combining data on traffic conditions, topography, meteorology and background pollution was used to relate 3-yrs averaged concentrations of major urban pollutants at the sites of schools to skin prick tests, exercise-induced asthma and reported asthma and allergies in 6,683 children (9–11 yrs) attending 108 schools randomly selected in six French communities. For the 4,907 children who had resided at their current address for the past 3 yrs, asthma (exercise induced, past year and lifetime) was significantly positively associated with benzene, SO2, particles with a 50% cut-off aerodynamic diameter of 10 &mgr;m (PM10), nitrogen oxides (NOx) and CO. In the same children, eczema (lifetime and past year) was significantly positively associated with benzene, PM10, NO2, NOx and CO, lifetime allergic rhinitis with PM10 and sensitisation to pollens with benzene and PM10. Among the 2,213 children residing at their current address since birth, the associations persisted for lifetime asthma with benzene (adjusted OR per interquartile range (95% CI) 1.3 (1.0–1.9)) and PM10 (1.4 (1.0–2.0)), and for sensitisation to pollens with volatile organic compounds (1.3 (1.0–1.9)) and PM10 (1.2 (1.0–1.9)). Accurately modelled urban air pollution was associated with some measures of childhood asthma and allergies.

Rapid Hymenoptera venom immunotherapy: comparative safety of three protocols

We compared 284 sting‐allergic patients treated with either a 4 day (group 1), 6 hr (group 2) or 210 min (group 3) rapid venom immunotherapy (RVIT) protocol using honey bee (HB) or yellow jacket (YJ) venom at cumulative doses of 527.6 μg, 226.6 μg and 101.1 μg respectively. The 4 day protocol involved four times as many injections as the 210 min protocol and twice as many as the 6 hr protocol. Desensitization was conducted in a hospital providing full emergency resuscitation facilities. In group 1, 1 × 100 μg boosters were given on days 7,10,15 and 45 and, in groups 2 and 3, 2 × 50 μg boosters were given on day 15 and 1 × 100 μg on day 45. The patients in the three groups were comparable with regard to clinical characteristics and immunological reactivity determined by skin tests. All patients had large local reactions. Systemic reactions (SR) occurred in 28.2% of patients in group 1, 28.6% in group 2 and 6.9% in group 3. The mean total cumulative venom dose (s.e.m.) for occurrence of SR was 123.75 (± 24.2) in group 1,183.27 (± 28.5) in group 2, and 36.43 (±9.3) in group 3. HB led to more systemic reactions than YJ venom. The rate of SR decreased when the cumulative venom dose was reduced during RVIT. The median dose was 137.6 μg in group 1, 226.6 μg in group 2, and 21.1 μg in group 3. No systemic reactions were observed after the booster injections. The results of this study suggest that short RVIT protocols with low cumulative doses carry a lesser risk of SR.

Allergy to cypress pollen

Although Cupressus sempervirens has been spread over southern Europe since antiquity, cypress pollen allergy has not been reported until 1945 ( 1 ). In France, the very first case reports were published in 1962 ( 2 ). Since then, the prevalence of cypress pollinosis seems to demonstrate an upward trend, concomitantly with the increased use of cypress trees as ornamental plants, as wind breaks and as hedges. Hyposensitization, using improved pollen extracts, is increasingly prescribed. Besides, prevention measures begin to be implemented. Such measures include avoidance of planting new cypress trees, especially near human populations’ centres, trimming of cypress hedges before the pollination season and agronomical research for hypoallergenic trees. Altogether, such new developments in cypress allergy deserve an update review.

Masitinib, a c‐kit/PDGF receptor tyrosine kinase inhibitor, improves disease control in severe corticosteroid‐dependent asthmatics

Background:  Masitinib is a tyrosine kinase inhibitor targeting stem cell factor receptor (c‐kit) and platelet‐derived growth factor (PDGF) receptor, which are expressed on several cell types including mast cells and bronchial structural cells, respectively. We hypothesized that c‐kit and PDGF receptor inhibition may decrease bronchial inflammation and interfere with airway remodeling, which are crucial features of severe asthma.

Prevalence of food allergy and its relationship to asthma and allergic rhinitis in schoolchildren

Background:  Food allergy (FA) is an important health problem. However, epidemiological studies at the population level are scarce. We assessed the prevalence of FA and its associations with respiratory manifestations among schoolchildren.

Atopy and systemic reactions to drugs

To elucidate whether systemic reactions (SR) to drugs should be included in the atopic status in epidemiological studies, we compared the distribution of atopy in subjects with or without a history of SR to drugs. The studied population comprised 2067 adults, 20 to 60 years old, visiting a health care center for a check‐up examination. The protocol included a questionnaire related to history of SR to drugs and a Phadiatop® test which evaluates on a blood sample the presence of specific IgE against common aeroallergens. Overall, 14.7% of the study group, including 66% women, reported reliable histories of SR to drugs. The cumulative prevalence of asthma, hay fever and childhood dermatitis was higher in the SR group. By contrast, the percentage of positive Phadiatop tests was similar in subjects with or without a history of SR. Thus atopy, defined by an objective criterion, i.e. the presence of specific IgE against common aero‐allergens, is not associated with the occurrence of SR to drugs. Such a history should not be included as part of the atopic status.