TY - JOUR
T1 - Clinical and immunologic studies among egg-processing workers with occupational asthma
AU - Bernstein, David I.
AU - Smith, Alexander B.
AU - Moller, David R.
AU - Gallagher, Joan S.
AU - Aw, Tar Ching
AU - London, Matthew
AU - Kopp, Shelby
AU - Carson, George
N1 - Funding Information:
Human hypersensitivity to egg proteins is commonly encountered in individuals with food-induced allergic reactions. This group is comprised largely of atopic individuals who develop food sensitivity early From the *Divisions of Immunology, Department of Medicine and •••Department of Environmental Health, University of Cincin-nati Medical Center, Cincinnati, and the ••National Institute for Occupational Safety and Health, Cincinnati, Ohio. SuppcHted by the National Institute for Occupational Safety and Health contract order number 85-34633. Received for publication Sept. 12, 1986. Accepted for publication May 19, 1987. Reprint requests: David I. Bernstein, M.D., University of Cincin-nati Medical Center, 231 Bethesda Ave., Cincinnati, OH 45267.
PY - 1987/12
Y1 - 1987/12
N2 - Twenty-five workers in an egg-processing factory were evaluated for respiratory sensitization to inhaled egg proteins by a physician evaluation, serial peak expiratory flow rate (PEFR) measurements for a 1-week period, and immunologic tests. Immunologic studies included skin prick tests, serum-specific IgE (RAST), and specific IgG (ELISA) to solutions prepared from commercial food allergens: factory-powdered egg white and yolk products and purified egg white fractions, including ovalbumin, ovomucoid, lysozyme, and conalbumin. Six workers had significant daily PEFR lability (>20%) of whom five had associated cutaneous reactivity to at least one egg allergen. A diagnosis of "definite asthma" was established in five workers suspected by the physician of having asthma. These five workers exhibited significant decrements in daily PEFR that were accompanied by bronchial symptoms. Occupational asthma was diagnosed by the physician in four of the five latter workers. Definite asthma was significantly associated with both cutaneous reactivity to egg allergens (p < 0.01) and RAST binding (p < 0.01). Of eight workers with cutaneous reactivity to at least one egg reagent, four workers (50%) were positive to only purified egg white fractions. The highest levels of RAST binding were detected in four workers, and the best binding activity was to ovomucoid and ovalbumin fractions. Elevated specific IgG responses were significantly higher in egg-factory workers to whole egg (p < 0.005), lysozyme (p < 0.002), and conalbumin (p < 0.002) allergens compared to responses of nonexposed control subjects. However, no differences in specific IgG were detected between symptomatic and asymptomatic workers. Thus, in four workers, the association of cutaneous reactivity with pulmonary function changes observed at work confirmed the physician-derived diagnosis of occupational asthma caused by inhalation of egg protein.
AB - Twenty-five workers in an egg-processing factory were evaluated for respiratory sensitization to inhaled egg proteins by a physician evaluation, serial peak expiratory flow rate (PEFR) measurements for a 1-week period, and immunologic tests. Immunologic studies included skin prick tests, serum-specific IgE (RAST), and specific IgG (ELISA) to solutions prepared from commercial food allergens: factory-powdered egg white and yolk products and purified egg white fractions, including ovalbumin, ovomucoid, lysozyme, and conalbumin. Six workers had significant daily PEFR lability (>20%) of whom five had associated cutaneous reactivity to at least one egg allergen. A diagnosis of "definite asthma" was established in five workers suspected by the physician of having asthma. These five workers exhibited significant decrements in daily PEFR that were accompanied by bronchial symptoms. Occupational asthma was diagnosed by the physician in four of the five latter workers. Definite asthma was significantly associated with both cutaneous reactivity to egg allergens (p < 0.01) and RAST binding (p < 0.01). Of eight workers with cutaneous reactivity to at least one egg reagent, four workers (50%) were positive to only purified egg white fractions. The highest levels of RAST binding were detected in four workers, and the best binding activity was to ovomucoid and ovalbumin fractions. Elevated specific IgG responses were significantly higher in egg-factory workers to whole egg (p < 0.005), lysozyme (p < 0.002), and conalbumin (p < 0.002) allergens compared to responses of nonexposed control subjects. However, no differences in specific IgG were detected between symptomatic and asymptomatic workers. Thus, in four workers, the association of cutaneous reactivity with pulmonary function changes observed at work confirmed the physician-derived diagnosis of occupational asthma caused by inhalation of egg protein.
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U2 - 10.1016/S0091-6749(87)80267-1
DO - 10.1016/S0091-6749(87)80267-1
M3 - Article
C2 - 3693757
AN - SCOPUS:0023580180
SN - 0091-6749
VL - 80
SP - 791
EP - 797
JO - The Journal of Allergy and Clinical Immunology
JF - The Journal of Allergy and Clinical Immunology
IS - 6
ER -