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EN
Objectives: To assess the effect of exposure to flour dust on pulmonary function tests, prevalence of symptoms (respiratory, allergic/irritating) and parameters of allergic sensitization in terms of skin prick test, and bronchial hyper-responsiveness. Material and Methods: 43 bakers (with at least 2 years of occupational exposure) working at different bakeries in Ismailia city, Egypt; and 64 control subjects of comparable socio demographic characteristics were compared. All participants were subjected to an interview questionnaire, clinical chest examination, skin prick test, bronchial hyper-responsiveness test and measurements of pulmonary function parameters. Results: All respiratory and allergic symptoms were more prevalent among bakers compared to the control group, with the highest odds ratio for allergic symptoms (OR = 6.9; p < 0.0001) and dyspnea (OR = 6.3; p = 0.0004). Bakers had a higher percentage of SPT positive results with statistically significant difference between the two groups (p < 0.0001). Bakers had lower observed values compared to the control group with statistically significant difference for FVC, FEV₁/FVC ratio, $ \text{FEF}_\text{75%} $, and $ \text{FEF}_\text{25-75%} $ parameters. Conclusion: The present study suggested that occupational exposure to flour dust may affect respiratory irritation and sensitization, and reduce the pulmonary function tests such as FVC, FEV₁, and FEV₁/FVC ratio and $ \text{FEF}_\text{25-75%} $.
EN
ObjectivesThe aim of this study was to determine the physiological and biochemical changes among bakers, induced by heat exposure at the workplace.Material and MethodsInformation was collected by means of a self-administered questionnaire. Vital signs were measured and recorded by a trained nurse before and after each work shift. A venous blood sample was drawn at the end of each work shift. The mean wet-bulb globe temperature (WBGT) index in the bakeries and offices was measured.ResultsThis was a cross-sectional study involving 137 bakers working in 20 bakeries, and 107 control subjects comparable in terms of age, race, marital status, years of service, income, and cigarette smoking. There was a significant weight loss and increase in the respiratory rate, the heart rate, and oral body temperature among the bakers compared to the control group. Sodium levels were significantly lower, while blood urea nitrogen levels were significantly higher, among the bakers than in the control group. There were unfavorably hot working conditions in the bakeries: the WBGT index in the bakeries was 37.4°C while the average WBGT for the offices was 25.5°C.ConclusionsThe changes in the physiological and biochemical parameters among the bakers were found to be associated with exposure to high environmental heat in the bakeries, as judged by the WBGT index. Preventive measures should be aimed at reducing the adverse effects of heat exposure among bakers and should be directed towards the man-machine-environment triad.
EN
Background The performance of specific inhalation challenge test (SICT) – reference method in diagnostics of occupational allergy – has some limitations due to health status of a particular patient. Therefore, it is extremely important to identify usefulness of other tests, and the evaluation of diagnostic accuracy of commercially available serum specific immunoglobulin E (sIgE) kits to the most common high molecular weight agents has been launched. Material and Methods The study group comprised 141 subjects – 110 bakers and 31 farmers – with suspicion of occupational airway allergy. All patients underwent evaluation of serum sIgE to occupational allergens with the use of Phadia and Allergopharma kits: in bakers to flour mix and α-amylase, in farmers to epithelium of cow, pig and feathers. Specific inhalation challenge test with workplace allergens performed in all subjects was a reference method for further analysis. Results Serum specific IgE to flour mix had the highest sensitivity (Phadia – 95.6%, Allergopharma – 88.3%), while its specificity was relatively low (Phadia – 47.8%, Allergopharma – 25%). There were numerous discrepancies between the results of sIgE estimation for particular single allergens (k87, e4, e83), as well as for their mixtures (fx901, fx20, ex71), performed with the kits of both companies (Phadia vs. Allergopharma). Conclusions Evaluation of serum specific IgE is characterized by inadequate sensitivity, specificity and predictive value to take the place of specific inhalation challenge test in diagnostics of occupational respiratory allergy. Med Pr 2017;68(1):31–43
PL
Wstęp Test swoistej prowokacji wziewnej – metoda referencyjna w diagnostyce alergii zawodowej – u niektórych chorych nie może być przeprowadzony z powodu przeciwwskazań zdrowotnych. Ponieważ ustalenie rzeczywistej przydatności innych testów jest niezwykle ważne, podjęto badanie, którego celem było określenie trafności i przydatności diagnostycznej dostępnych komercyjnie odczynników do oznaczania alergenowo swoistych przeciwciał immunoglobuliny E (asIgE) w surowicy w diagnostyce IgE-zależnej alergii dróg oddechowych na najczęstsze alergeny pochodzenia roślinnego. Materiał i metody Badaniem objęto grupę 141 pacjentów – 110 piekarzy i 31 rolników – z podejrzeniem zawodowej alergii dróg oddechowych. U wszystkich badanych oznaczono asIgE dla alergenów zawodowych w surowicy odczynnikami firm Phadia i Allergopharma: u piekarzy dla mieszaniny mąk i α-amylazy, u rolników dla alergenów naskórka krowy, naskórka świni i mieszaniny piór. Metodę referencyjną do oceny powyższych testów diagnostycznych stanowił wykonany u wszystkich badanych test swoistej prowokacji wziewnej z alergenami z miejsca pracy. Wyniki Najwyższą czułością charakteryzowały się oznaczenia asIgE dla alergenów mąk (Phadia – 95,6% i Allergopharma – 88,3%), przy stosunkowo niskiej swoistości (Phadia – 47,8% i Allergopharma – 25%). Rozbieżności między wynikami uzyskanymi przy użyciu zestawów Phadia vs Allergopharma dotyczyły oznaczeń asIgE zarówno dla pojedynczych alergenów (k87, e4, e83), jak i mieszanin alergenów (fx901, fx20, ex71). Wnioski Oznaczanie asIgE w surowicy nie charakteryzuje się wystarczającą czułością, swoistością i wartością predykcyjną, żeby zastąpić test swoistej prowokacji wziewnej w diagnostyce zawodowej alergii dróg oddechowych. Med. Pr. 2017;68(1):31–43
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