Environmental and Occupational Disorders
Time course of onset of sensitization to common and occupational inhalants in apprentices

https://doi.org/10.1067/mai.2003.1341Get rights and content

Abstract

Background: Incident sensitization to common allergens in the setting of sensitization to an occupational allergen has not been described. Objective: Our aim was to determine the risk and timing of development of sensitization to common allergens in subjects with incident sensitization to a work-related allergen. Methods: Data from a cohort of 769 apprentices in animal-health technology, pastry making, and dental hygiene were used. Skin prick tests to work-related allergens (laboratory animal, flour, and latex) and common allergens (mites, molds, pets, and pollen) were administered at baseline and at up to 3 subsequent annual visits. Risk ratios (RRs) and 95% CIs were calculated. Results: Eighty-three subjects had sensitization to a work-related allergen. Four (4.8%) subjects became sensitized to common and then occupational allergens. Nine (10.8%) subjects had sensitization to a common allergen after sensitization to a work-related allergen. In 20 (24.1%) subjects new sensitizations to specific and common allergens were detected simultaneously. Fifty subjects remained free from new sensitization to occupational allergen during development of sensitization to common allergens. An increased risk of development of sensitization to molds (RR = 3.49) and pets (RR = 2.51) was found in subjects with incident sensitization to occupational allergens relative to the risk in subjects without sensitization. Conclusion: New sensitization to common aeroallergens is frequent in subjects not previously exposed to work-related allergens; it often occurs around the same time as sensitization to work-related agents. Subjects with new occupational sensitization are at a greater risk of development of sensitization to common aeroallergens than subjects without sensitization.

Section snippets

Subjects

A cohort of 769 apprentices (417 in animal-health technology, 230 in pastry making, and 122 in dental-hygiene technology) was constituted by recruiting students from teaching institutions in Quebec, Canada, in a process described elsewhere.4 The subjects were recruited on entering their training programs and considered eligible if they had not been exposed to the relevant work-related allergen for 3 months or more in the course of an apprenticeship. Those in animal-health technology were

Results

Among the 769 subjects included in this study, 698 participated in at least one of the follow-up visits; 690 had interpretable skin test results and have been included in the analysis. There were 394 subjects in the animal-health program, 186 in the pastry-making program, and 110 in the dental-hygiene program. The numbers and characteristics of the participants present during follow-up visits have been described in a previous publication.7 Briefly, 85% of subjects were female, 55.2% were

Discussion

The parallel time course of sensitization to common inhalants and occupational high-molecular-weight agents in exposed apprentices has not, to our knowledge, been described. We found the following over the maximum 44-month observation period: (1) once sensitization to an occupational high-molecular-weight agent occurs, there was often incident sensitization to common allergens as well (33/83 [39.8%] subjects); (2) incident sensitization to common and occupational inhalants was most often

Acknowledgements

We thank Michèle Magnan, RN, who worked on the recruitment of subjects, and Jocelyne L’Archevêque, RT, who was involved in the database management. We also thank Lori Schubert, who revised the manuscript.

References (20)

There are more references available in the full text version of this article.

Cited by (24)

  • Inverse association between rural environment in infancy and sensitization to rodents in adulthood

    2007, Annals of Allergy, Asthma and Immunology
    Citation Excerpt :

    One approach toward evaluating whether early childhood exposures confer long-lasting protection against sensitization is to study adults exposed to allergens in the workplace. Laboratory animal research facilities provide an opportunity to study sensitization among adults, because approximately 1% to 5% of workers become sensitized to rodent allergens per year during the first few years of employment.9-11 Because mouse allergen is commonly found in dust12,13 and air14 samples in US homes, rodent sensitization (RS) among some adults may be attributable to nonoccupational exposure.

  • Advances in environmental and occupational diseases 2003

    2004, Journal of Allergy and Clinical Immunology
  • Occupational asthma

    2016, Textbook of Allergy for the Clinician
View all citing articles on Scopus

Reprint requests: Denyse Gautrin, PhD, Department of Chest Medicine, Sacré-Coeur Hospital, 5400 Gouin Blvd West, Montreal, Canada H4J 1C5.

View full text