Walusiak J

Respiratory allergy in apprentice bakers: do occupational allergies follow the allergic march?

Background:  This prospective study describes the incidence, risk factors and natural history of occupational respiratory allergy in apprentice bakers.

Occupational asthma and rhinitis due to glutaraldehyde: changes in nasal lavage fluid after specific inhalatory challenge test.

Background: Glutaraldehyde (GA) is a known respiratory sensitizers, and some studies have reported occupational asthma in exposed workers. Specific changes in nasal lavage fluid (NLF) induced by high‐molecular‐weight allergen provocation in sensitized subjects were described previously. The purpose of this study was to evaluate the changes in cytogram, protein content, eosinophil cationic protein (ECP), and mast‐cell tryptase concentrations in NLF after GA inhalation challenge in patients with a positive history of GA‐induced asthma and late or dual asthmatic response due to exposure to low‐level GA.

Prediction of challenge test results by flour-specific IgE and skin prick test in symptomatic bakers.

Background:  Wheat and rye flours are among the most important allergens causing occupational asthma. Usually, the diagnosis of baker’s asthma is based on inhalation challenge tests with flours.

Nasal provocation test in the diagnosis of natural rubber latex allergy

Background: Natural rubber latex (NRL) allergy in workers using rubber gloves has been an occupational health problem for the last 10 years. In the case of the occupational agents, clinical history may be far from conclusive; hence, appropriate provocation should be carried out. The objective was to evaluate the usefulness of the nasal challenge test in the diagnosis of allergic rhinitis in subjects occupationally exposed to NRL.

Exhaled Nitric Oxide Levels After Specific Inahalatory Challenge Test in Subjects with Diagnosed Occupational Asthma

OBJECTIVES Measuring exhaled nitric oxide (eNO) is a useful method for the assessment of bronchial inflammation in asthmatic subjects. The aim of the study was to evaluate the changes in eNO level in the subjects with suspected occupational asthma (OA) after a specific inhalation test (SIT) with occupational agents. MATERIALS AND METHODS Forty two patients, including 17 farmers, 15 bakers and 10 health care workers had a physical examination, skin prick tests with common and occupational allergens, total serum IgE level, specific anti-allergen IgE determinations, spirometry and SIT. Also, morphological changes in induced sputum (ISP) and nasal lavage fluid (NLF) were analysed and eNO measurements were performed. RESULTS SIT revealed a significant increase in the proportion of eosinophils in NLF and in ISP in the cases with diagnosed OA. Moreover, these cases showed significantly increased eNO levels only 24 h after SIT, compared to the measurements before SIT. We also found a significant correlation between eNO level at 24 h after SIT and the percentage of eosinophils in NLF before, and 4 and 24 h after SIT, as well as in ISP before and 24 h after SIT in all subjects with diagnosed OA. CONCLUSION The findings may confirm the usefulness of exhaled nitric oxide measurements for diagnosing OA.

Comparison of wheat and rye flour solutions for skin prick testing: a multi-centre study (Stad 1).

Background Skin prick testing (SPT) is the basic method for diagnosing IgE‐mediated allergies. However, skin reactivity is related to the quality of allergen extracts, which are often poorly defined for occupational allergens.

Eotaxin but not MCP−3 induces eosinophil influx into nasal fluid in allergic patients

Background: Eotaxin and MCP‐3 (CC chemokines), owing to their preferential action on eosinophils, seem to be the very importance in the patophysiology of allergic rhinitis and asthma. The purpose of this study was to examine the effect of intranasally administered eotaxin and MCP‐3 after specific allergen priming on the influx of inflammatory cells and their soluble mediators into the nasal mucosa.

Small nonspecialized farming as a protective factor against immediate‐type occupational respiratory allergy?

Background:  In Poland small, nonspecialized farms, growing different crops and raising usually a few animals of various species constitute the majority.

IL-18 Levels in Nasal Lavage After Inhalatory Challenge Test with Flour in Bakers Diagnosed with Occupational Asthma

OBJECTIVES The authors discuss the outcomes of a study on IL-18 concentration in nasal washings after the inhalatory challenge test with flour allergens (ICHT-F) in bakers with flour-induced occupational airway allergy (OAA). METHODS We measured IL-18 concentration using ELISA kit and assessed morphological changes in nasal lavage fluid (NLF) before, and 4 h and 24 h after ICHT-F in three groups of subjects: Group A - 9 patients with diagnosed OAA (occupational asthma and rhinitis), Group B - 10 patients with atopic asthma and rhinitis, and Group C - 9 healthy volunteers. RESULTS In Group A, significant differences in the basophil proportion in NLF were noted only 24 h after ICHT-F. Both the basophil proportion and total eosinophil count were higher in Group A than in Group C at this time-point. Group A also showed a statistically significant increase in IL-18 levels 4 h after the challenge. A significant relationship was noted between the proportion of basophils 4 h after ICHT-F and IL-18 level at 24 h after the test. CONCLUSIONS This is the first study demonstrating an increased expression of IL-18 in nasal washings of subjects diagnosed with OAA to flour allergens. The observed higher concentrations of IL-18 in nasal washings after ICHT as well as the increase in the proportion of basophils provide evidence for the important role of IL-18 in persistent allergic inflammation.

Latex allergy in Polish nurses

BACKGROUND Reports on the studies conducted in Western Europe and North America revealed that from 2.8 to 16.9% of the health care personnel were allergic to latex. No respective data are available from Eastern European countries. METHODS A postal questionnaire inquiring about the history of latex-induced allergic reactions was distributed among 3,750 nurses. The participation rate was 77.3%. To verify the results of the survey, in randomly selected nurses, skin prick tests with latex and tropical fruit allergens, evaluation of total IgE, and specific anti-latex IgE, skin and nasal provocation with latex were performed. RESULTS Allergic symptoms in the workplace were reported by 1,016 subjects (35%); out of this group 847 (29.2%) persons associated the symptoms with latex exposure. The group of cases with self-reported latex allergy revealed a significantly increased frequency of history of atopy, allergy to beta-lactam antibiotics and tropical fruits. Allergy to latex was confirmed in 33.3% of randomly selected nurses with a positive history of occupational allergy. It was found that 18.6% of nurses working at hospital wards were allergic to latex. The 95% CI was estimated to be 13.5-23.6%. CONCLUSIONS Latex allergy is an important health problem among nurses in Poland. Atopy, allergy to beta-lactam antibiotics and tropical fruits, are the risk factors for latex allergy.