Sensitisation to common allergens and respiratory symptoms in endotoxin exposed workers: a pooled analysis

Ioannis Basinas; Vivi Schlünssen; Dick Heederik; Torben Sigsgaard; Lidwien A.M. Smit; Sadegh Samadi; Øyvind Omland; Charlotte Hjort; Anne Mette Madsen; Simon Skov; Inge M. Wouters

doi:10.1136/oem.2011.065169

Sensitisation to common allergens and respiratory symptoms in endotoxin exposed workers: a pooled analysis

Ioannis Basinas, Vivi Schlünssen, Dick Heederik, Torben Sigsgaard, Lidwien A.M. Smit, Sadegh Samadi, Øyvind Omland, Charlotte Hjort, Anne Mette Madsen, Simon Skov, Inge M. Wouters

43 Citations (Scopus)

Abstract

Objective: To test the hypotheses that current endotoxin exposure is inversely associated with allergic sensitisation and positively associated with non-allergic respiratory diseases in four occupationally exposed populations using a standardised analytical approach. Methods: Data were pooled from four epidemiological studies including 3883 Dutch and Danish employees in veterinary medicine, agriculture and power plants using biofuel. Endotoxin exposure was estimated by quantitative job-exposure matrices specific for the study populations. Dose - response relationships between exposure, IgE-mediated sensitisation to common allergens and self-reported health symptoms were assessed using logistic regression and generalised additive modelling. Adjustments were made for study, age, sex, atopic predisposition, smoking habit and farm childhood. Heterogeneity was assessed by analysis stratified by study. Results: Current endotoxin exposure was dose-dependently associated with a reduced prevalence of allergic sensitisation (ORs of 0.92, 0.81 and 0.66 for low mediate, high mediate and high exposure) and hay fever (ORs of 1.16, 0.81 and 0.58). Endotoxin exposure was a risk factor for organic dust toxic syndrome, and levels above 100 EU/m ³ significantly increased the risk of chronic bronchitis (p<0.0001). Stratification by farm childhood showed no effect modification except for allergic sensitisation. Only among workers without a farm childhood, endotoxin exposure was inversely associated with allergic sensitisation. Heterogeneity was primarily present for biofuel workers. Conclusions: Occupational endotoxin exposure has a protective effect on allergic sensitisation and hay fever but increases the risk for organic dust toxic syndrome and chronic bronchitis. Endotoxin's protective effects are most clearly observed among agricultural workers.

Original language	English
Journal	Occupational and Environmental Medicine
Volume	69
Pages (from-to)	99-106
Number of pages	8
ISSN	1351-0711
DOIs	https://doi.org/10.1136/oem.2011.065169
Publication status	Published - Feb 2012

Access to Document

10.1136/oem.2011.065169

Cite this

@article{82d23c8c4a7648cc9f023326d3111804,

title = "Sensitisation to common allergens and respiratory symptoms in endotoxin exposed workers: a pooled analysis",

abstract = "Objective: To test the hypotheses that current endotoxin exposure is inversely associated with allergic sensitisation and positively associated with non-allergic respiratory diseases in four occupationally exposed populations using a standardised analytical approach. Methods: Data were pooled from four epidemiological studies including 3883 Dutch and Danish employees in veterinary medicine, agriculture and power plants using biofuel. Endotoxin exposure was estimated by quantitative job-exposure matrices specific for the study populations. Dose - response relationships between exposure, IgE-mediated sensitisation to common allergens and self-reported health symptoms were assessed using logistic regression and generalised additive modelling. Adjustments were made for study, age, sex, atopic predisposition, smoking habit and farm childhood. Heterogeneity was assessed by analysis stratified by study. Results: Current endotoxin exposure was dose-dependently associated with a reduced prevalence of allergic sensitisation (ORs of 0.92, 0.81 and 0.66 for low mediate, high mediate and high exposure) and hay fever (ORs of 1.16, 0.81 and 0.58). Endotoxin exposure was a risk factor for organic dust toxic syndrome, and levels above 100 EU/m 3 significantly increased the risk of chronic bronchitis (p<0.0001). Stratification by farm childhood showed no effect modification except for allergic sensitisation. Only among workers without a farm childhood, endotoxin exposure was inversely associated with allergic sensitisation. Heterogeneity was primarily present for biofuel workers. Conclusions: Occupational endotoxin exposure has a protective effect on allergic sensitisation and hay fever but increases the risk for organic dust toxic syndrome and chronic bronchitis. Endotoxin's protective effects are most clearly observed among agricultural workers.",

author = "Ioannis Basinas and Vivi Schl{\"u}nssen and Dick Heederik and Torben Sigsgaard and Smit, {Lidwien A.M.} and Sadegh Samadi and {\O}yvind Omland and Charlotte Hjort and Madsen, {Anne Mette} and Simon Skov and Wouters, {Inge M.}",

year = "2012",

month = feb,

doi = "10.1136/oem.2011.065169",

language = "English",

volume = "69",

pages = "99--106",

journal = "Occupational and Environmental Medicine",

issn = "1351-0711",

publisher = "B M J Group",

}

TY - JOUR

T1 - Sensitisation to common allergens and respiratory symptoms in endotoxin exposed workers

T2 - a pooled analysis

AU - Basinas, Ioannis

AU - Schlünssen, Vivi

AU - Heederik, Dick

AU - Sigsgaard, Torben

AU - Smit, Lidwien A.M.

AU - Samadi, Sadegh

AU - Omland, Øyvind

AU - Hjort, Charlotte

AU - Madsen, Anne Mette

AU - Skov, Simon

AU - Wouters, Inge M.

PY - 2012/2

Y1 - 2012/2

N2 - Objective: To test the hypotheses that current endotoxin exposure is inversely associated with allergic sensitisation and positively associated with non-allergic respiratory diseases in four occupationally exposed populations using a standardised analytical approach. Methods: Data were pooled from four epidemiological studies including 3883 Dutch and Danish employees in veterinary medicine, agriculture and power plants using biofuel. Endotoxin exposure was estimated by quantitative job-exposure matrices specific for the study populations. Dose - response relationships between exposure, IgE-mediated sensitisation to common allergens and self-reported health symptoms were assessed using logistic regression and generalised additive modelling. Adjustments were made for study, age, sex, atopic predisposition, smoking habit and farm childhood. Heterogeneity was assessed by analysis stratified by study. Results: Current endotoxin exposure was dose-dependently associated with a reduced prevalence of allergic sensitisation (ORs of 0.92, 0.81 and 0.66 for low mediate, high mediate and high exposure) and hay fever (ORs of 1.16, 0.81 and 0.58). Endotoxin exposure was a risk factor for organic dust toxic syndrome, and levels above 100 EU/m 3 significantly increased the risk of chronic bronchitis (p<0.0001). Stratification by farm childhood showed no effect modification except for allergic sensitisation. Only among workers without a farm childhood, endotoxin exposure was inversely associated with allergic sensitisation. Heterogeneity was primarily present for biofuel workers. Conclusions: Occupational endotoxin exposure has a protective effect on allergic sensitisation and hay fever but increases the risk for organic dust toxic syndrome and chronic bronchitis. Endotoxin's protective effects are most clearly observed among agricultural workers.

AB - Objective: To test the hypotheses that current endotoxin exposure is inversely associated with allergic sensitisation and positively associated with non-allergic respiratory diseases in four occupationally exposed populations using a standardised analytical approach. Methods: Data were pooled from four epidemiological studies including 3883 Dutch and Danish employees in veterinary medicine, agriculture and power plants using biofuel. Endotoxin exposure was estimated by quantitative job-exposure matrices specific for the study populations. Dose - response relationships between exposure, IgE-mediated sensitisation to common allergens and self-reported health symptoms were assessed using logistic regression and generalised additive modelling. Adjustments were made for study, age, sex, atopic predisposition, smoking habit and farm childhood. Heterogeneity was assessed by analysis stratified by study. Results: Current endotoxin exposure was dose-dependently associated with a reduced prevalence of allergic sensitisation (ORs of 0.92, 0.81 and 0.66 for low mediate, high mediate and high exposure) and hay fever (ORs of 1.16, 0.81 and 0.58). Endotoxin exposure was a risk factor for organic dust toxic syndrome, and levels above 100 EU/m 3 significantly increased the risk of chronic bronchitis (p<0.0001). Stratification by farm childhood showed no effect modification except for allergic sensitisation. Only among workers without a farm childhood, endotoxin exposure was inversely associated with allergic sensitisation. Heterogeneity was primarily present for biofuel workers. Conclusions: Occupational endotoxin exposure has a protective effect on allergic sensitisation and hay fever but increases the risk for organic dust toxic syndrome and chronic bronchitis. Endotoxin's protective effects are most clearly observed among agricultural workers.

U2 - 10.1136/oem.2011.065169

DO - 10.1136/oem.2011.065169

M3 - Journal article

SN - 1351-0711

VL - 69

SP - 99

EP - 106

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

ER -

Sensitisation to common allergens and respiratory symptoms in endotoxin exposed workers: a pooled analysis

Abstract

Access to Document

Fingerprint

Cite this