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Original Article
Exposure to polycyclic aromatic hydrocarbons and serum total IgE in the Korean adults: the Third Korean National Environmental Health Survey (2015–2017)
Jeong Hun Jo, Dae Hwan Kim, Ji Young Ryu
Ann Occup Environ Med 2022;34:e43.   Published online December 14, 2022
DOI: https://doi.org/10.35371/aoem.2022.34.e43
AbstractAbstract AbstractAbstract in Korean PDFPubReaderePub
Background

Polycyclic aromatic hydrocarbons (PAHs) have become common pollutants with industrial development. Although the effect of exposure to PAHs on allergic disease in humans has been evaluated, evidence of an association is sparse. The association between PAH exposure and serum total immunoglobulin E (IgE) levels was evaluated in Korean adults.

Methods

In total, this study included 3,269 participants in the Third Korean National Environmental Health Survey (2015–2017). Four urinary PAH metabolites were used to assessed exposure to PAHs: 1-hydroxypyrene, 1-hydroxyphenanthrene, 2-naphthol, and 2-hydroxyfluorene. The analyses were performed on 3 cutoff levels (100 IU/mL, 114 IU/mL, and 150 IU/mL) set as the total IgE elevation. Prevalence of total IgE elevation by PAH exposure group and general characteristics (age, sex, BMI, smoking, alcohol drinking, and occupation) were analyzed using the Rao–Scott χ2 test. Multiple logistic regression analyses were conducted to calculate adjusted odds ratios (ORs) for total IgE elevation by PAH exposure groups.

Results

Total IgE elevation differed significantly by age, sex, smoking status, alcohol drinking status, and occupation. For 2-hydroxyfluorene, the fourth quartile showed a significant association with IgE elevation compared to the first quartile in the analyses of cutoff-level 100 IU/mL (OR: 1.372, 95% confidence interval [CI]: 1.007–1.869) and 114 IU/mL (OR: 1.643, 95% CI: 1.167–2.312). In the analysis of cutoff-level 150 IU/mL, the adjusted ORs of the third and fourth quartile of 2-hydroxyfluorene were significantly higher than the first quartile (3rd quartile: OR: 1.478, 95% CI: 1.034–2.113; 4th quartile: OR: 1.715, 95% CI: 1.161–2.534). However, there were no significant positive associations for the other metabolites.

Conclusions

This study implied that PAHs exposure is associated with total IgE elevation in Korean adults. More research is needed to confirm the effect of exposure to PAHs on serum IgE and allergic diseases.

다환 방향족 탄화수소 노출과 혈중 총 면역글로불린 E (제3기 국민환경보건 기초조사 2015-2017)
목적
다환 방향족 탄화수소(Polycyclic Aromatic Hydrocarbons, PAHs)는 화석 연료, 폐기물, 목재 등의 여러 유기물의 불완전 연소에 의해서 발생하는 환경 및 직업상 오염물질로서, 산업 발전으로 인해 생활 곳곳에서 노출이 가능한 오염물질이 되었다. PAHs노출과 알레르기 질환과의 관련성을 보여주는 연구 결과들이 있으나 부족한 실정이다. 본 연구에서는 제3기 국민환경보건기초조사(2015-2017) 자료를 이용하여 국내 성인에서 PAHs 노출과 알레르기 지표 중 하나인 혈중 총 면역글로불린 E(IgE)의 관련성을 평가하였다.
방법
국민환경보건 기초조사(2015 - 2017) 제3기에 참여한 성인 3269명을 대상으로 가중치를 적용하여 분석하였다. PAHs에 대한 노출에 대한 지표로 요중 1-hydroxypyrene, 2-naphthol, 1-hydroxyphenanthrene, 2-hydroxyfluorene 농도를 이용하였고, 혈중 total IgE의 증가 여부는 100 IU/mL, 114 IU/mL, 150 IU/mL를 기준으로 설정하여 분석하였다. 요중 PAHs 대사체 농도는 사분위수 기준 네 그룹으로 나누어 분석에 이용하였다.
나이, 성별, BMI, 흡연 여부, 알코올 섭취 여부, 직업군 등 인구학적 요인에 따른 혈중 total IgE 증가 여부 및 각 대사체의 사분위수 그룹에 따른 혈중 total IgE 증가 여부를 카이제곱 검정을 이용하여 분석하였다. 로지스틱 회귀분석을 이용하여 요중 PAHs 대사체 농도 사분위수 그룹과 혈중 total IgE 농도 증가와의 관련성을 파악하고자 하였다.
결과
총 IgE 상승은 연령, 성별, 흡연 여부, 음주 여부, 직업에 따라 유의한 차이를 보였다.
나이, 성별, 흡연 여부, 알코올 섭취 여부, 직업군 등 요인들을 보정한 로지스틱 회귀분석에서는 2-hydroxyfluoren의 경우 IgE 증가를 100IU/mL 및 114IU/mL로 설정한 분석에서 4사분위수 그룹이 1사분위수 그룹과 비교하여 혈중 total IgE 증가에 대해 유의하게 높은 교차비를 보였다(100 IU/mL을 IgE 증가 기준으로 분석 시: OR 1.372, 95% CI 1.007-1.869; 114 IU/mL을 IgE 증가 기준으로 분석 시: OR 1.643, 95% CI 1.167-2.312). 혈중 total IgE의 증가를 150IU/mL로 설정한 분석에서는 2-hydroxyfluoren의 3사분위 그룹과 4분위수 그룹의 total IgE 증가에 대한 교차비가 1사분위수 그룹과 비교하여 유의하게 더 높았다(3사분위수 그룹: OR 1.478, 95% CI 1.034-2.113; 4사분위수그룹: OR 1.715, 95% CI 1.161-2.534). 그러나 다른 대사 산물들에 대한 분석에서는 유의한 연관성이 없었다.
결론
본 연구의 결과는 한국 성인의 PAHs 노출과 총 IgE 수준 사이에 연관성이 있음을 제시한다. PAHs 노출이 혈청 IgE와 알레르기 질환에 미치는 영향을 평가하기 위해서는 추가적인 연구가 더 필요할 것으로 보인다.

Citations

Citations to this article as recorded by  
  • Association of mixed polycyclic aromatic hydrocarbons exposure with oxidative stress in Korean adults
    Ji Young Ryu, Dong Hyun Hong
    Scientific Reports.2024;[Epub]     CrossRef
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  • 1 Web of Science
  • 1 Crossref
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Research Article
Association between the prevalence of allergic reactions to skin prick tests and workplace types among agricultural workers in South Korea
Jiyoung Han, Yangwoo Kim, Sooyeon Lee, Soo-Jin Lee
Ann Occup Environ Med 2020;32:e36.   Published online November 11, 2020
DOI: https://doi.org/10.35371/aoem.2020.32.e36
AbstractAbstract PDFPubReaderePub
Background

Farmers are often exposed to dust, molds, pollen, animal products, insects, and chemicals. Accordingly, they have a high prevalence of respiratory and allergic diseases. Some studies have shown that farmers have a high prevalence of respiratory diseases and symptoms depending on where farmers work. The objective of the present study was to investigate whether certain types of agricultural workplaces are associated with the prevalence of allergic reactions in skin prick tests (SPTs) in South Korea.

Method

A total of 149 farmers, grouped according to their workplaces in greenhouses, poultry houses, or outdoors, answered a self-reported questionnaire about the prevalence of respiratory diseases and symptoms. They were skin-tested using 12 allergens. The questionnaire and the prevalence of positive skin tests were determined for each of the participant groups, and the results were analyzed by multivariate logistic regression.

Results

There were significant differences in the prevalence of allergic reactions to the SPT, chronic obstructive pulmonary diseases (COPDs) and asthma symptoms (wheezing) among the subgroups. The allergic reaction to SPT was the highest in greenhouse workers (30.9%), followed by poultry house workers (15.9%), and outdoor workers (8.1%). The prevalence of COPD was 6.8% in poultry house workers alone and not in other groups. The prevalence of wheezing was the highest at 9.1% in poultry house workers. According to the results of the logistic analysis, the prevalence of allergic reactions to SPT had positive correlations with the types of workplaces. Greenhouse workers had higher risk of SPT sensitization compared to outdoor workers (adjusted odds ratio [OR]: 5.55, 95% confidence interval [CI]: 1.32–32.24). The prevalence of SPT positivity also had an association with the symptoms of sneezing, rhinorrhea, or nasal congestion (adjusted OR: 6.64, 95% CI: 2.06–23.63).

Conclusions

These data demonstrate that the types of workplaces were associated with the prevalence of allergic sensitization. This could be explained by the difference in the type or level of airborne exposures in each workplace. It is also likely that this was caused by differences between groups of individual factors such as age and BMI that influence SPT sensitization.


Citations

Citations to this article as recorded by  
  • New Developments in Climate Change, Air Pollution, Pollen Allergy, and Interaction with SARS-CoV-2
    Gennaro D’Amato, Isabella Annesi-Maesano, Benedetta Biagioni, Andrea Lancia, Lorenzo Cecchi, Maria Concetta D’Ovidio, Maria D’Amato
    Atmosphere.2023; 14(5): 848.     CrossRef
  • Comparison of Overall Immunity Levels among Workers at Grape Orchard, Rose Greenhouse, and Open-Field Onion Farm
    Anju Maharjan, Ravi Gautam, JiHun Jo, Manju Acharya, DaEun Lee, Pramod Bahadur K C, Jin Gim, Sojung Sin, Hyocher Kim, ChangYul Kim, SooYeon Lee, SooJin Lee, Yong Heo, HyoungAh Kim
    Safety and Health at Work.2022; 13(2): 248.     CrossRef
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  • 3 Web of Science
  • 2 Crossref
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Case Report
A Case of Hypersensitivity Pneumonitis with Giant Cells in a Female Dental Technician
Yong-Hyun Kim, Yun Kyung Chung, Changhwan Kim, Eun suk Nam, Hyun-Jun Kim, Youngsu Joo
Ann Occup Environ Med 2013;25:19-19.   Published online October 4, 2013
DOI: https://doi.org/10.1186/2052-4374-25-19
AbstractAbstract PDFPubReaderePub
Objectives

Dental technicians are exposed to methyl methacrylate(MMA) and hard metal dusts while working, and several cases of hypersensitivity pneumonitis caused by the exposure have been reported. The authors experienced a case of hypersensitivity pneumonitis in a female dental technician who had 10 years’ work experience and report the case with clinical evidence.

Method

The patient’s work, personal, social, and past and present medical histories were investigated based on patient questioning and medical records. Furthermore, the workplace conditions and tools and materials the patient worked with were also evaluated. Next, the pathophysiology and risk factors of pneumonitis were studied, and studies on the relationship between hypersensitivity pneumonitis and a dental technician’s exposure to dust were reviewed. Any changes in the clinical course of her disease were noted for evaluation of the work-relatedness of the disease.

Results

The patient complained of cough and sputum for 1 year. In addition, while walking up the stairs, the patient was not able to ascend without resting due to dyspnea. She visited our emergency department due to epistaxis, and secondary hypertension was incidentally suspected. Laboratory tests including serologic, electrolyte, and endocrinologic tests and a simple chest radiograph showed no specific findings, but chest computed tomography revealed a centrilobular ground-glass pattern in both lung fields. A transbronchial biopsy was performed, and bronchoalveolar washing fluid was obtained. Among the findings of the laboratory tests, microcalcification, noncaseating granuloma containing foreign body-type giant cells, and metal particles within macrophages were identified histologically. Based on these results, hypersensitivity pneumonitis was diagnosed. The patient stopped working due to admission, and she completely quit her job within 2 months of restarting work due to reappearance of the symptoms.

Conclusion

In this study, the patient did not have typical radiologic findings, but pathological evaluation of the lung biopsy from the bronchoscope led to the suspicion of pneumonitis. Under the microscope, the sample contained fibrotic changes in the lung, multinucleated giant cells, and particles in macrophages and was diagnosed as dental technician pneumoconiosis by the pathology. Working as a dental technician had directly exposed her to light metal dust and MMA, and her clinical symptoms and radiologic findings subsided after withdrawal from exposure to the workplace. These outcomes led to the diagnosis of hypersensitity pneumonitis due to MMA exposure and strong work-relatedness.


Citations

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  • Interstitial pulmonary disease and aluminum trihydrate exposure: A single case report and detailed workplace analysis
    Claudia Corwin, Hillary Waterhouse, Jerrold L. Abraham, Soma Sanyal, Judith A. Crawford, Matthew Caddell, Michael J. Hodgson
    American Journal of Industrial Medicine.2024; 67(3): 274.     CrossRef
  • The effect of Eucalyptol on SOD and IL-10 expression in mice exposed to Methyl methacrylate vapor
    Sianiwati Goenharto, Elly Rusdiana, Sherman Salim, I Ketut Sudiana
    Research Journal of Pharmacy and Technology.2021; : 2999.     CrossRef
  • Assessment and Management of Occupational Hypersensitivity Pneumonitis
    Iñigo Ojanguren, Vincent Ferraro, Julie Morisset, Xavier Muñoz, Jordan Fink, María Jesús Cruz
    The Journal of Allergy and Clinical Immunology: In Practice.2020; 8(10): 3295.     CrossRef
  • Hard Metal Lung Disease: Update in Diagnosis and Management
    Matthew Zheng, Robert M. Marron, Sameep Sehgal
    Current Pulmonology Reports.2020; 9(2): 37.     CrossRef
  • Hard Metal Lung Disease with Favorable Response to Corticosteroid Treatment: A Case Report and Literature Review
    Yosuke Chiba, Takashi Kido, Masahiro Tahara, Keishi Oda, Shingo Noguchi, Toshinori Kawanami, Mitsuru Yokoyama, Kazuhiro Yatera
    The Tohoku Journal of Experimental Medicine.2019; 247(1): 51.     CrossRef
  • Small Airways Disease Related to Occupational Exposures
    Mridu Gulati, Ann Teng
    Clinical Pulmonary Medicine.2015; 22(3): 133.     CrossRef
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  • 7 Web of Science
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Case Report
Hot Tub Lung Due to Mycobacterium Avium Complex in a Public Bath
Chung Won Kang, Yun Kyung Chung, Hye Eun Lee, Eun A Kim, Yun Chul Hong, Soo Hun Cho
Korean Journal of Occupational and Environmental Medicine 2010;22(2):166-172.   Published online June 30, 2010
DOI: https://doi.org/10.35371/kjoem.2010.22.2.166
AbstractAbstract PDF
BACKGROUND
Hot tub lung is a hypersensitivity pneumonitis caused by nontuberculous mycobacteria (NTM); the primary causative agent is Mycobacterium avium complex (MAC) post contaminated water exposure. Recently, 2 cases of hot tub lung were found in public bath bodyscrubbers working in Korea. However, the disease causing NTM was not identified in these cases. Here, we reported one case, along with clinical diagnostic approach to occupational medicine throughout worksite investigation.
CASE
A 53 year-old woman working in the public bath for 13 months' duration developed shortness of breath. She had been cleaning the locker room, several pools and floors every day, and using scrubbers with detergent and warm water. After examination, the patient was diagnosed with hypersensitivity pneumonitis based on high resolution computerized tomography and lung biopsy. Because the Mycobacterium avium was identified in both the patient's sputum and the warm pool, she was diagnosed with hot tub lung due to MAC.
CONCLUSION
Hot tub lung due to MAC was confirmed in public bath housekeeper. However, few cases have been reported, even though there are many cases. To prevent damages caused by hot tub lung, general environmental management such as ventilation and cleaning is important for bath operators. Likewise, awareness needs to be increased in workers with potential NTM environmental exposure and in clinicians through education about hot tub lung in order to reduce adverse harm from misdiagnosis and mistreatment of tuberculosis.

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Case Report
A Case of Hypersensitivity Pneumonitis in a Worker Exposed to Metal Working Fluid
Sun Wung Lee, Dong hee Ko, Ku Won Chin, Dong Uk Park, Jung Tak Lee, Yoon Hee Song, Sang Yoon Lee
Korean Journal of Occupational and Environmental Medicine 2008;20(1):37-45.   Published online March 31, 2008
DOI: https://doi.org/10.35371/kjoem.2008.20.1.37
AbstractAbstract PDF
INTRODUCTION: There have been no reports of hypersensitivity pneumonitis caused by metal working fluids in Korea, despite their existence in other countries. Here, we report the first such case, along with an assessment of work-relatedness through exposure assessment.
CASE
REPORT: A 64-year old male patient visited the hospital with dyspnea after metal pipe cutting for about a year. He was diagnosed with hypersensitivity pneumonitis from the evidence of specific exposure history, clinical symptoms, and radiologic findings. The air exposure levels of the oil mist, endotoxin, total bacteria and fungus in the work environment was TWA(8-hr) 0.531 mg/m3, 6.33 EU/m3, 100 CFU/m3 and 75 CFU/m3, respectively. The concentrations of the endotoxin, total bacteria and fungus within the metal working fluid was 1.5x10(4) EU/mL, 4.6x10(5) CFU/mL and 1.8x10(5) CFU/mL, respectively.
DISCUSSION
Although the patient did not receive a specific precipitating antibody test, the microbial concentration within the metal working fluid was higher than normal and similar to previous case reports, The oil mist level in the air exceeded the NIOSH REL and ACGIH NIC, and were similar or higher than previous cases. By excluding other causes of hypersensitivity pneumonitis, we concluded that the disease developed from exposure to microbial antigens in the metal working fluid.

Citations

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  • Green manufacturing—performance of a biodegradable cutting fluid
    Rahul Katna, Kanwarjeet Singh, Narayan Agrawal, Swati Jain
    Materials and Manufacturing Processes.2017; 32(13): 1522.     CrossRef
  • Association of Exposure to Chemicals with Dyspnea among Employed Workers: Analysis of the 3rdKorean Working Conditions Survey
    Moon-Young Park, Sung-Ho Hwang, Kimyong Hong, Se-Eun Oh, Kyoung-Mu Lee
    Journal of Korean Society of Occupational and Environmental Hygiene.2016; 26(1): 64.     CrossRef
  • Microbial Assessment in Metal-Working Fluids Handling Industry
    Hyunhee Park, Dongjin Park, Hae Dong Park
    Journal of Korean Society of Occupational and Environmental Hygiene.2014; 24(3): 300.     CrossRef
  • Microbial Exposure Assessment in Sawmill, Livestock Feed Industry, and Metal Working Fluids Handling Industry
    Hyunhee Park, Haedong Park, Inseop Lee
    Safety and Health at Work.2010; 1(2): 183.     CrossRef
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  • 4 Crossref
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Original Article
Investigation of Occupational Dermatological Problem with Additives in Polypropylene Manufacturing Process
Seung Ho Jeon, Kyong Min Lee, Kan Woo Yoon, Do Myung Paek, Jong Yeop Yoo, Hee Chul Eun
Korean Journal of Occupational and Environmental Medicine 2003;15(3):252-260.   Published online September 30, 2003
DOI: https://doi.org/10.35371/kjoem.2003.15.3.252
AbstractAbstract PDF
OBJECTIVES
To investigate the causative agents for the dermatological problems associated with the polypropylene manufacturing process.
METHODS
The study subjects consisted of 44 male workers involved in the polypropylene manufacturing process. Twenty-seven of them had been exposed to additives, and the remaining 17 had not. Among the 27 exposed, 10 had been exposed previously, and 17 are currently being exposed through their duties. Patch test were performed with three different concentrations, 0.1%, 1% and 10% of 10 different additives that was diluted with Vaseline.
RESULTS
18 subjects (41%) had positive reactions to the patch tests. Exposed group had a higher reaction rate (51.9%) than the control group (23.5%). When the positive reactions were further classified, 7, 6 and 5 were compatible with probably irritant, probably allergic, and multiple hypersensitivity reactions respectively. The most frequent reactions were from Ultranox-626 followed by Millad 3988, Armoslip-E and Songstab Sc-100.
CONCLUSIONS
When considering the significantly higher probability of an allergic reaction rate among the currently exposed group compared to non- or previously-exposed groups, the nature of dermatological problems in a polypropylene plant is probably allergic. Ultranox-626, Millad3988, Armoslip-E and Songstab Sc-100 were the main causatives agents found in the process.

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