Comparative serological and clinical findings in subjects exposed to environmental allergens

1365-2222

Blackwell Publishing Journal Backfiles 1879-2005

Medicine

Serological tests of healthy atopic and non-atopic subjects were carried out during medical surveillance of 288 workers in detergent and food manufacturing factories in the same highly industrialized area. Correlations between the serological parameters and various aspects of the clinical history were compared for subgroups in these and control populations. The value of serological tests as aids in the diagnosis of allergic reactivity to the detergent enzyme Alcalase was given particular attention.There was no indication that employment in the detergent factory significantly increased the amount of serum total IgG, IgA or IgM. There was a positive correlation between the amount of serum total IgE and atopy as defined. The need for new standards of normality in the amount of serum total α1-antitrypsin in women receiving oral contraceptives was confirmed. No subjects had a homozygous deficiency of α1-antitrypsin.There was a statistically significant correlation between the level of allergen-specific antibody measured by the RAST and skin prick test weals of 3·0 mm diameter or greater, which were obtained using standardized skin prick test procedure and reagents. The significance of small skin prick test reactions has been evaluated critically.The results of various tests for allergen-specific precipitating antibodies indicated the need for caution in interpreting the results of such tests with allergens such as Alcalase, which contain several antigenic components. Alcalase-specific IgG antibodies were only detected in the sera of persons exposed to enzyme dusts in factories. They were evidence of exposure to the antigens, not of a clinical allergic response, and probably reflect the natural formation of antibody shown to occur with numerous environmental antigens.

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