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 Safety
Food and Chemical Risk Analysis
Adult
Allergens
Endotoxins
Epidemiology
Hypersensitivity
IgE
Occupational exposure
allergen
endotoxin
histamine
immunoglobulin E
adult
agricultural worker
article
atopy
blood sampling
confidence interval
controlled study
experimental model
geometry
human
lung function
major clinical study
male
medical examination
nonlinear system
occupational exposure
parameter
prevalence
priority journal
regression analysis
respiratory tract allergy
risk assessment
risk factor
statistical model
swine
Adult
Agricultural Workers' Diseases
Agriculture
Animals
Bronchial Provocation Tests
Endotoxins
Humans
Hypersensitivity, Immediate
Immunoglobulin E
Occupational Exposure
Prevalence
Respiratory Function Tests
Sus 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