Print Email Facebook Twitter Endotoxin exposure and atopic sensitization in adult pig farmers Title Endotoxin exposure and atopic sensitization in adult pig farmers Author Portengen, L. Preller, L. Tielen, M. Doekes, G. Heederik, D. TNO Kwaliteit van Leven Publication year 2005 Abstract Background: Recent studies have reported a low prevalence of atopic sensitization and respiratory allergy in children growing up on farms. Objectives: We sought to evaluate the dose-response relationship between endotoxin and atopic sensitization in adult farmers and to assess the effect on respiratory health outcomes. Methods: Data on endotoxin exposure and serum IgE levels were available for 162 pig farmers from a cross-sectional case-control study, with case selection on the basis of respiratory symptoms. Exposure to endotoxin was modeled in detail, and respiratory health effects were assessed during a medical examination. Exploratory analysis was done by using nonparametric modeling and was followed by classical parametric regression. Results: IgE to one or more common allergens was detected in sera from 28 (17%) farmers. The average (geometric mean) total serum IgE levels was 37 IU/mL (geometric SD, 4 IU/mL). A strong inverse relationship was found between endotoxin and sensitization to common allergens for exposures of 75 ng/m 3 or less, with an odds ratio of 0.03 (95% CI, 0.0-0.34) for a 2-fold increase in endotoxin. For endotoxin exposure of greater than 75 ng/m 3, the association was weak (odds ratio, 1.2 [95% CI, 0.38-3.6]). No association was found between endotoxin exposure and total serum IgE levels. Endotoxin was associated with increased airway hyperresponsiveness to histamine and lower lung function in sensitized farmers, without evidence of a nonlinear relationship. Conclusions: The prevalence of atopic sensitization in adult pig farmers is low. Endotoxin or related exposures might protect from sensitization, even in an adult working population exposed to high levels of endotoxin, but is a risk factor for increased airway hyperresponsiveness and low lung function. © 2005 American Academy of Allergy, Asthma and Immunology. Subject Chemistry SafetyFood and Chemical Risk AnalysisAdultAllergensEndotoxinsEpidemiologyHypersensitivityIgEOccupational exposureallergenendotoxinhistamineimmunoglobulin Eadultagricultural workerarticleatopyblood samplingconfidence intervalcontrolled studyexperimental modelgeometryhumanlung functionmajor clinical studymalemedical examinationnonlinear systemoccupational exposureparameterprevalencepriority journalregression analysisrespiratory tract allergyrisk assessmentrisk factorstatistical modelswineAdultAgricultural Workers' DiseasesAgricultureAnimalsBronchial Provocation TestsEndotoxinsHumansHypersensitivity, ImmediateImmunoglobulin EOccupational ExposurePrevalenceRespiratory Function TestsSus scrofa To reference this document use: http://resolver.tudelft.nl/uuid:679fefe3-6ca2-4a40-8212-ed5bb5c547d0 DOI https://doi.org/10.1016/j.jaci.2004.11.046 TNO identifier 238431 ISSN 0091-6749 Source Journal of Allergy and Clinical Immunology, 115 (4), 797-802 Document type article Files To receive the publication files, please send an e-mail request to TNO Library.