Utility of Antibody in Identifying Individuals Who Have or Will Develop Anhydride-induced Respiratory Disease

doi:10.1378/chest.114.4.1199

Chest

Volume 114, Issue 4, October 1998, Pages 1199-1202

https://doi.org/10.1378/chest.114.4.1199 Get rights and content

Objective

To define the utility of serum antibody against trimellitic anhydride (TMA) in predicting which individuals employed, at Amoco Corporation, in the manufacture of TMA have or will develop immunologically mediated respiratory disease, such as asthma, due to exposure to TMA.

Methods

In 1990 we initiated a clinical and immunologic cross-sectional study of 181 subjects exposed to TMA for at least 1 year who had not been diagnosed with an immunologic respiratory disease. We then clinically and immunologically followed 119 of these subjects for the next 5 years to determine whether they would develop an immunologic respiratory disease due to TMA exposure.

Results

Of the 16 individuals with IgE against TMA conjugated to human serum albumin (TM-HSA) in 1990, 3 had immediate asthma and another 6 developed asthma during the 5-year follow-up. Of the 165 individuals without IgE against TM-HSA, none had immediate asthma in 1990 and only 1 of 102 individuals followed for 5 years developed asthma. Of the 44 subjects with IgG against TM-HSA, 6 had an immunologic respiratory disease in 1990 and 2 more developed it in the ensuing 5 years. Of the 137 subjects without IgG against TM-HSA, none had an immunologic respiratory disease in 1990 and none of the 80 subjects followed for 5 years developed it.

Conclusions

Development of antibody against TM-HSA, both IgE and IgG, is predictive of subjects who have or will develop immunologically mediated respiratory disease due to TMA exposure. The absence of antibody is a potent negative predictor.

Section snippets

Study Population

The subjects of the study population consisted of 181 employees of Amoco Corporation at a facility that manufactures TMA. Of these subjects, 119 were followed longitudinally for the subsequent 5 years.

Exposure

An exposure class was assigned to each subject by an industrial hygienist at the manufacturing facility. This assignment of class was based on personal monitoring of representative subjects in each exposure class and a detailed knowledge of each job category. The exposure classification was ranked

Study Population

The demographic, clinical, exposure, and serologic data collected on this study population of 181 subjects are summarized in Table 1. The mean age was 41 years (range, 20 to 67 years). All but 20 were male; 14 were nonwhite and 168 were white. The proportions of smokers, exsmokers, and nonsmokers were similar. In terms of exposure classification, most were in the lower exposure classes. Sixteen had specific IgE at a level high enough to cause disease (1:10), whereas 44 had specific IgG at a

DISCUSSION

Acid anhydrides have been known to cause immunologically mediated asthma for more than 2 decades.10, 11 New acid anhydrides causing asthma continue to be reported,12, 13 and new anhydride-induced IgG-mediated respiratory disease has also been described.¹⁴

It is well recognized that development of either IgE or IgG antibody to a variety of occupational antigens is not necessarily associated with disease.10, 15 We have reported the predictive value, sensitivity, and specificity of IgG and IgE

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Parmi ces acquisitions, une attention particulière sera portée aux aspects suivants : (1) l’allongement de la liste étiologique et la reconnaissance de nouveaux antigènes en milieu professionnel et les implications pratiques qui en découlent, (2) au niveau diagnostique, l’apport de l’imagerie tomodensitométrique, qui montre souvent des images caractéristiques, mais aussi l’identification récente de critères diagnostiques « simples » susceptibles d’être utilisés dans l’approche épidémiologique, (3) l’importance de la composante bronchique et la fréquence de l’évolution vers une maladie obstructive avec emphysème, enfin (4) la remise en cause du dogme de l’éviction antigénique totale et la possibilité de maintenir, dans certaines situations et sous réserve de mesures préventives, les activités professionnelles.
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Supported by the Ernest S. Bazley Grant to Northwestern Memorial Hospital and Northwestern University Medical School and Amoco Corporation

Reprints of the pulmonary disease prevention survey results may be requested through the corresponding author

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Chest

Occupational and Environmental Lung DiseaseUtility of Antibody in Identifying Individuals Who Have or Will Develop Anhydride-induced Respiratory Disease

Objective

Methods

Results

Conclusions

Section snippets

Study Population

Exposure

Study Population

DISCUSSION

Immunology and immunopathology of trimellitic anhydride pulmonary reactions. J Allergy Clin Immunol

j Allergy Clin Immunol

Chest

J Allergy Clin Immunol

Syndromes in workers exposed to trimellitic anhydride: a longitudinal clinical and immunologic study

Ann Intern Med

A clinical and immunologic study of employees in a facility manufacturing trimellitic anhydride

Allergy Proc

Four year evaluation of workers exposed to trimellitic anhydride

J Occup Med

Six-year clinical and immunologic follow-up of workers exposed to trimellitic anhydride

J Allergy Clin Immunol

Occupational and Environmental Lung Disease
Utility of Antibody in Identifying Individuals Who Have or Will Develop Anhydride-induced Respiratory Disease