title: Allergic and latex-specific sensitization: route, frequency, and amount of exposure that are required to initiate IgE production.
abstract: Quantitative data that documents human exposure-response relationships for IgE sensitization to allergens are limited. Although seemingly straightforward, documentation of exposure-response relationships can be difficult. Issues that are related to study design, allergen standardization, exposure assessment, and evaluation for sensitization can impact greatly on study results. Despite these issues, exposure-response relationships for sensitization to protein allergens have been documented in several occupational groups, which include enzyme-detergent workers, bakers, and laboratory animal workers. In general, atopy acts as an effect modifier in these settings, steepening the exposure-response relationship. Several studies suggest that the greatest risk for sensitization is within the first several years of exposure. For 1 allergen, the protease subtilisin, a short-term exposure limit of 60 ng/m(3) has been recommended by the American Council of Governmental Industrial Hygienists. With regard to natural rubber latex, exposure-related factors such as number of operations have been shown to be risk factors for sensitization of children with spina bifida. By contrast, fewer studies show exposure-response relationships for IgE sensitization of health care workers to natural rubber latex, and the area remains controversial. However, a recent cohort study that evaluated incident sensitization in dental hygiene students suggests strongly that, with sufficient exposure, employment in health care can lead to an increased risk of IgE sensitization to natural rubber latex.
authors.affiliation: National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Morgantown, WV 26505, USA. dweiss-man@cdc.gov
authors.forename: David N
authors.initials: DN
authors.lastname: Weissman
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Lewis
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects / Q000276:immunology*; D000485:Allergens / Q000009:adverse effects / Q000276:immunology*; D000818:Animals; D004781:Environmental Exposure; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology*; D007114:Immunization; D007073:Immunoglobulin E / Q000096:biosynthesis*; D007840:Latex / Q000009:adverse effects / Q000276:immunology*; D020315:Latex Hypersensitivity / Q000276:immunology*; D009784:Occupational Diseases / Q000276:immunology*; D012107:Research Design
chemical_list: D000395:Air Pollutants, Occupational; D000485:Allergens; D007840:Latex; D007073:Immunoglobulin E