title: High prevalence of immunoglobulin E (IgE) sensitization among sisal (Agave sisalana) processing workers in Tanzania.
abstract: OBJECTIVE
  Allergic sensitization among workers exposed to sisal is scarcely documented. We examined whether sisal processing is associated with IgE sensitization and its relationship to the prevalence of respiratory symptoms among Tanzanian processors.
  
  
  METHODS
  138 sisal exposed workers and 78 non-exposed controls were skin prick tested (SPT) using dry sisal extract and fresh sisal sap. Sera from a subset of 43 participants were analyzed for total and sisal specific IgE. SPT wheal size, prevalence of positive SPTs and adjusted relative risk (RR) for sisal sensitization were determined and compared between exposed and controls. Prevalences for respiratory symptoms were compared between sensitized and non-sensitized sisal workers.
  
  
  RESULTS
  Significantly higher prevalence of positive SPTs to sisal was found among 74 % of sisal workers compared to 17 % among controls. Compared to controls, the RR of sensitization to sisal was 4 times higher (95 % CI; 2.4-6.7) among exposed workers. All exposed workers had elevated IgE levels (>100 kU/l) and 27 % of tested sera had elevated sisal specific IgE. A high prevalence of respiratory symptoms was found in both sensitized and non-sensitized sisal workers.
  
  
  CONCLUSIONS
  Sisal processing is associated with increased risk of IgE sensitization, but its clinical implication is not obvious.
authors.affiliation: Research Group on Occupational and Environmental Medicine, Department of Public Health and Primary Care, University of Bergen, Kalfarveien 31, Bergen, Norway. akwilina.kayumba@gmail.com
authors.forename: Akwilina V
authors.initials: AV
authors.lastname: Kayumba
authors.forename: Thien
authors.initials: T
authors.lastname: Van-Do
authors.forename: Erik
authors.initials: E
authors.lastname: Florvaag
authors.forename: Magne
authors.initials: M
authors.lastname: Bråtveit
authors.forename: Valborg
authors.initials: V
authors.lastname: Baste
authors.forename: Yohana
authors.initials: Y
authors.lastname: Mashalla
authors.forename: Wijnand
authors.initials: W
authors.lastname: Eduard
authors.forename: Bente E
authors.initials: BE
authors.lastname: Moen
mesh_terms: D000293:Adolescent; D000328:Adult; D027882:Agave / Q000009:adverse effects / Q000737:chemistry / Q000276:immunology*; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000139:chemically induced / Q000453:epidemiology*; D000395:Air Pollutants, Occupational / Q000633:toxicity; D016022:Case-Control Studies; D003371:Cough; D004391:Dust; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D012120:Respiration Disorders / Q000139:chemically induced / Q000453:epidemiology*; D012882:Skin Tests; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust; D007073:Immunoglobulin E