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A steady increase in the incidence of allergic diseases can be observed since 1950s. For such atopic diseases as bronchial asthma, pollinosis or atopic dermatitis, a significantly increased morbidity rate in the general population has been found. Strikingly enough, the highest prevalence of asthma and allergy was recorded in highly developed countries. It can thus be assumed that the high rate of asthma may be an attribute of the post-industrial societies. The prevalence of occupational allergies is thought to be in direct proportion to the rate with which allergies occur in the general population. In view of the changing environment and lifestyles in the developing countries, their communities are expected to be faced with similar negative epidemiological effects concerning allergies. To counteract the spreading of negative health effects, the following measures need to be undertaken: [Copyright &y& Elsevier]

The paper reviews the literature reports on low molecular weight (LMW) sensitizers that are commonly encountered in the work environment as well as on the major mechanisms responsible for their effect on the immune cells of the respiratory tract. Current studies have focused on: LMW-antigens; the role of airway epithelial and dendritic cells (DCs); activation of naive helper T (Th) cells by DCs; naive B cell-effector Th2 cell interactions; and activation of mast cells by LMW asthmogens. A better understanding of the pathogenesis of occupational asthma due to LMW asthmogens should facilitate the development of better diagnostics and the improvement of strategies for disease surveillance and intervention. [ABSTRACT FROM AUTHOR]

Objectives: Chloramine T is a known sensitising agent in the occupational environment of health care workers. In cases of occupational hazards induced by this agent,a clinical history may be far from conclusive, hence appropriate provocation tests are absolutely essential. The aim of the study was to evaluate the usefulness of the nasal challenge test in diagnostics of respiratory allergy to chloramine T. Materials and Methods: A single-blind, placebo-controlled study was conducted in 6 subjects with chloramine T asthma and rhinitis. Two control groups comprised 7 atopic subjects with asthma and rhinitis and 6 healthy persons. All the controls had negative results of skin prick tests with chloramine T and none displayed any respiratory symptoms under exposure to the agent. A "nasal pool" technique was used to evaluate morphological and biochemical parameters (mast cell tryptase, eosinophil cationic protein, permeability index) in nasal washings before and 30 min, 4 h and 24 h after the provocation with chloramine T and placebo. Results: A significant increase was found in the total count and percentage of eosinophils and basophils, albumin, tryptase and eosinophil cationic protein levels in the nasal lavage fluid from patients with chloramine T respiratory allergy when compared to both control groups. Also a dual asthmatic reaction in 4 patients and an isolated late reaction in 2 cases were observed in chloramine-sensitive subjects. Conclusions: The results indicate the applicability of the "nasal pool" technique as a diagnostic procedure in chloramine T-induced airway allergy. [ABSTRACT FROM AUTHOR]

Introduction: Bronchial asthma is one of the frequent chronic diseases in elderly persons. Global data show that 6.5-17% of the elderly suffer from asthma. However, there are no Polish data available on asthma prevalence in this group. Aim: This article is a retrospective analysis of the Polish Multicentre Study of Epidemiology of Allergic Diseases (PMSEAD) results aimed at assessing prevalence and clinical characteristics in the elderly. Material and methods: The study was conducted in 1998-1999 in 11 research centres in Poland, including the Lodz centre. The study included randomly selected subjects of both sexes. Demographics and prevalence were assessed among adults (aged 16-80 years) based on the nationwide database and the detailed clinical analysis was based on the Lodz centre database. Results: Nationwide data were obtained from 12 970 adults, including 1057 respondents in the Lodz Province; 20.3% of respondents in Poland and 23.6% in the Lodz Province were over 60 years of age. In both groups, elderly participants significantly more frequently suffered from asthma (asthma prevalence in this group was 6.7% for Poland and 12.0% for the Lodz Province). The multivariate analysis demonstrated that age over 60 years (OR = 2.08), residence in the city centre (OR = 3.30), and occurrence of seasonal allergic rhinitis (OR = 3.11) were significant risk factors for asthma occurrence among the residents of the Lodz Province. Among the elderly in Lodz, almost 50% of patients with asthma had not had a proper diagnosis made despite reporting clinical symptoms. Conclusions: In Poland asthma is a common and frequently underdiagnosed disease in the elderly. [ABSTRACT FROM AUTHOR]

Background. Contact allergy among adolescents is an important issue. Objectives. To assess the prevalence of contact allergy to metals in adolescents aged 15 years and nickel release from metal accessories that are in direct contact with the skin. Methods. Three hundred and nine females and 219 males, all 15 years old, from randomly selected secondary schools were examined and patch tested with nickel sulfate, cobalt chloride, palladium chloride, and potassium dichromate. Three hundred and ninety-nine metal accessories were tested with the dimethylglyoxime (DMG) test. Results.'Metal dermatitis' was reported by 19.4% of females and 0.5% of males. Positive patch test reactions were found in 8.5% of the adolescents (12.9% in females; 2.3% in males), namely to: nickel (12.3% of females; 1.4% of males); palladium (5.2% of females; 0.5% of males); cobalt (3.2% of females; 1.4% of males); and chromium (1.3% of females; 0.9% of males). Allergic contact dermatitis caused by metals was diagnosed in 9.7% of females and in 0.5% of males. Of the metal items, 26.1% gave positive DMG test results: 10.0% of earrings, 11.4% of snaps, and 56.2% of belt buckles. Conclusions. Despite the implementation of the Nickel Directive in Poland, nickel still remains an important causal factor for allergic contact dermatitis. Numerous metal accessories do not comply with the Directive. [ABSTRACT FROM AUTHOR]

Objectives: About 5-10% of asthmatics do not respond well to standard treatment plan. Occupational exposure may be one of the factors that can be linked with treatment failure. The aim of the study was to assess the prevalence of work-related asthma (WRA) among adult asthmatics under follow up in an outpatient allergy clinic and to create a useful tool for detecting individuals with possible WRA.Material and Methods: Preliminary 5-question questionnaire designed to recognize WRA was presented to 300 asthmatics. All patients with positive preliminary verification along with 50 subjects from control group were asked to fill up a detailed questionnaire. The WRA was diagnosed by positive match for asthma symptoms in combination with workplace exposure indicated in the detailed WRA questionnaire followed by confirmation of each WRA case by detailed exposure analysis.Results: Work-related asthma was recognized in 63 subjects (21% of study group). The preliminary questionnaire has 76.9% sensitivity and 94% specificity in recognition of WRA. Occupational exposure to irritants is a risk factor of WRA recognition (relative risk (RR) = 2.09 (1.44:3.03)). Working in exposure-free environment is a factor against WRA recognition (RR = 0.38 (0.24:0.61)). Among subjects with work-related asthma, the uncontrolled course of the disease is significantly more frequent (p = 0.012). Subjects with WRA more often report sickness absenteeism due to asthma than those without WRA (9.6% vs. 3.2%, respectively), but the observed differences did not reach the statistical significance.Conclusions: Short 5-question questionnaire seems to be a promising tool to detect individuals with possible work-related asthma in the outpatient setting for further evaluation and additional attention. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to evaluate health effects of occupational exposure to diisocyanates (DIC) among polyurethane foam products factory workers.Material and Methods: Thirty workers had a physical examination, skin prick tests with common allergens, allergen-specific immunoglobulin E (IgE) antibodies to diisocyanates and pulmonary function tests. Concentrations of selected isocyanates in the workplace air samples as well as concentration of their metabolites in the urine samples collected from the workers of the plant were determined.Results: The most frequent work-related symptoms reported by the examined subjects were rhinitis and skin symptoms. Sensitization to at least 1 common allergen was noted in 26.7% of the subjects. Spirometry changes of bronchial obstruction of a mild degree was observed in 5 workers. The specific IgE antibodies to toluene diisocyanate (TDI) and 4,4'-methylenebis(phenyl isocyanate) (MDI) were not detected in any of the patients' serum. Cellular profiles of the collected induced sputum (ISP) did not reveal any abnormalities. Air concentrations of TDI isomers ranged 0.2-58.9 μg/m3 and in 7 cases they exceeded the Combined Exposure Index (CEI) value for those compounds. Concentrations of TDI metabolites in post-shift urine samples were significantly higher than in the case of pre-shift urine samples and in 6 cases they exceeded the British Biological Monitoring Guidance Value (BMGV - 1 μmol amine/mol creatinine). We didn't find a correlation between urinary concentrations of TDI, concentrations in the air and concentrations of toluenediamine (TDA) in the post shift urine samples. Lack of such a correlation may be an effect of the respiratory protective equipment use.Conclusions: Determination of specific IgE in serum is not sensitive enough to serve as a biomarker. Estimation of concentrations of diisocyanate metabolites in urine samples and the presence of work-related allergic symptoms seem to be an adequate method for occupational exposure monitoring of DIC, which may help to determine workers at risk as well as to recognize hazardous workplaces. [ABSTRACT FROM AUTHOR]

Objectives: There is insufficient data on the prevalence of latex allergy in the general population in Poland. The aim of the study was to evaluate natural rubber latex (NRL) sensitization and its risk factors among Polish blood donors. Materials and Methods: The study group comprised 1000 consecutive blood donors attending the Regional Centre for Transfusion Medicine. Total IgE and allergen specific IgE to NRL (asNRL-IgE) were assayed using the EIA (enzyme immunoassay) test. In the subjects with asNRL-IgE equal to or above Class II further surveys were performed: questionnaire, skin prick tests (SPT) to common allergens, NRL and food allergens cross reactive to NRL, asNRL-IgE with FDA (Food and Drug Administration) approved FEIA (fluorescent enzyme immunoassay) test and antigen profile of asNRL-IgE. Results: asNRL-IgE (EIA) was observed in 17.9% of blood donors. Only 10% of positive results equal to or above Class II were confirmed with the FEIA test. The positive FEIA results were confirmed with SPT to NRL in 60% and the negative FEIA results in 5.4% of cases. The specific IgE to Hev b 3,5,6 and 13 were observed in the subjects with occupational exposure to NRL. The highest concentration of Hev b 8 was observed in the subjects not symptomatic to NRL with positive SPT to grass and tree pollens. Conclusion: The EIA test showed the high prevalence of antigen specific IgE to NRL among Polish blood donors. There was low concordance between EIA and FEIA tests. Therefore, the EIA test should be used only for screening purposes along with the establishment of sensitivity and specificity of the method. Elevated total IgE level, active tobacco smoking, and history of atopic disease symptoms were revealed to be risk factors for the presence of asNRL-IgE. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the study was to analyze morphological and biochemical changes in induced sputum after the provocation with occupational allergens (mixture of flours and grains) in subjects with diagnosed occupational asthma. Materials and Methods: Subjects with occupational asthma and healthy volunteers had physical examination, skin prick tests with common and occupational allergens, and spirometry. Specific IgE against common and occupational allergens was also measured. Bronchial inflammation was characterized by the percentage of cells, levels of eosinophil cationic protein (ECP), and changes in mucosal permeability index. Results: There was a significant increase in the proportion of eosinophils, basophils, lymphocytes, and in the ECP level in induced sputum of occupational allergics after the specific provocation. Conclusion: Sputum induction is a reliable method for measuring allergen-induced airway inflammation. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of the study was to compare cytological and biochemical changes in nasal lavage fluid induced by wheat flour inhalatory challenge in bakers with allergic rhinitis and with asthma accompanied by rhinitis. Materials and Methods: A single-blind, placebo controlled study was conducted in 64 bakers with allergic rhinitis (n =17), bronchial asthma and rhinitis (n =24) and without occupational allergy (n =23). Nasal washings were examined before, 30 min, 4 and 24 h after the specific provocation, wheras non-specific bronchial hyperreactivity (PC20) before and after 24 h. Results: A significant decrease in PC20 after the challenge test was observed only in patients with asthma and rhinitis. Eosinophil count and percentage, basophil count and the permeability index induced by specific provocation were significantly increased in both rhinitis patients and asthmatics. Moreover, the increase especially in total count and proportion of eosinophils as well as in the permeability index was more pronounced in subjects suffering from asthma and rhinitis than in those with rhinitis alone, although the changes were not statistically significant. Conclusions: The results indicate the applicability of the "nasal pool" technique as a simple diagnostic procedure in flour-induced airway allergy. However, the evaluation of nasal lavage fluid, although a very sensitive and specific method of diagnosing respiratory allergic disease, cannot be used to distinguish patients with upper and lower airway allergy. [ABSTRACT FROM AUTHOR]

Objectives:The purpose of this study was to compare the cellular and biochemical findings in the nasal lavage fluid (NALF) and nasal resistance changes due to a challenge with laboratory animal allergens in 25 patients with occupational asthma and rhinitis,in 22 patients with atopic asthma and rhinitis sensitized to house dust mite,and in 15 healthy subjects.Methods:Skin prick tests with common and occupational allergens,total serum IgE level,specific anti -allergens IgE,spirometry and nasal lavages were performed.Results:In patients with occupational airway allergy,nasal symptoms of varying severity developed directly after specific nasal challenge.The total symptom score immediately and 24 h after specific challenge was significantly correlated with expiratory nasal resistance (ENR).The percentage of eosinophils and basophils in NALF increased signi . cantly 5 and 24 h after specific challenge in patients with occupational asthma and it was correlated with ENR.The authors did not observe any significant increase in the percentage of eosinophils,basophils and in the level of albumin in NALF of patients with non-occupational allergy and healthy subjects at any time-point after specific challenge. None of the healthy subjects and patients with non-occupational allergy developed either allergic symptoms or increased ENR after the challenge with laboratory animal allergens and placebo.Conclusions:The prolonged increase in the percentage of eosinophils,basophils and in the level of albumin seems to reflect allergic inflammation.The intensity of inflammation during the specific reaction is related to the symptom score and to ENR in occupational allergics. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 45 year old atopic woman, with a history of asthma. She was employed as a packer of herbs and her duties mainly consisted of putting flowerpots of herbs into plastic bags. She developed pruritic erythema and blistering on the backs of the hands and also complained of shortness of breath and rhinitis.

The article presents a case report of cobalt-induced anaphylaxis, contact urticaria and delayed allergy in a 39-year-old ceramics decorator. The paper provides information on the patient's medical history, clinical presentation of the disease, results of medical examinations and treatment and management of the disease.

Discusses the case of a female patient with occupational allergic contact dermatitis caused by padauk wood. Signs and symptoms; Medical history; Patch and prick skin testing.