Allergy Development in Adulthood: An Occupational Cohort Study of the Manufacturing of Industrial Enzymes.

BACKGROUND: Occupational allergy may serve as a model of allergy development in adults. OBJECTIVE: We aimed at describing respiratory allergy and IgE sensitization across different exposure strata defined by time, technology, and exposure control. METHODS: In a retrospective (1970-2017) cohort of industrial enzyme production employees, monitored by an occupational medical center, 5024 individuals were surveyed. Five exposure groups and risk levels for sensitization and allergic disease were analyzed on the basis of demographic characteristics, hiring decade, and smoking status. RESULTS: Of all persons entering the company 47 years from 1970, 149 developed occupational allergy (incidence rate, 2.72/1000 person-years). In a multivariate cause-specific Cox proportional hazards model, the hazard of allergy was significantly related to decade of recruitment. Compared with the 1970s, the hazard ratio (HR) uniformly decreased from 0.85 (95% CI, 0.57-1.27) in the 1980s to 0.16 (95% CI, 0.05-0.52) in the 2010s. Compared with expected highest exposed group, the HRs were 0.48 (95% CI, 0.31-76) and 0.13 (95% CI, 0.06-0.30) in less exposed production areas and 0.92 (95% CI, 0.48-1.73) and 0.23 (95% CI, 0.10-0.53) in different laboratory areas. The HR of smoking was 2.03 (95% CI, 1.41-2.93). The pattern of sensitizations also showed clear associations to recruitment decade, exposure, and smoking. Among individuals sensitized but not yet allergic, a high IgE level was the only risk factor (HR, 3.03; 95% CI, 1.82-5.04) for subsequent allergy development. CONCLUSIONS: The impact of exposure is dose-related and linked to the sensitization step, which may subsequently lead to allergy development. For primary prevention of enzyme allergy, exposure control is mandatory and achievable despite increasing production volumes.

Increased pancreas cancer in a bio-technological research laboratory.

BACKGROUND: Pancreatic cancer is extremely rare among people under 55 years old. Its prognosis is poor, and the causal background remains almost unresolved. A previous study observed an increased occurrence of pancreatic cancer in workers in a French biochemical laboratory. CASE REPORT: During an approximate 10 year period in a Danish bio-chemical laboratory with about 50 stable employees, four cases of pancreatic cancer have been diagnosed at a mean age of 53 years. Approximately 0.02 cases should be expected if the laboratory employees had experienced the same rate of pancreatic cancer as that observed in the respective general Danish populations. RESULT: All the four cases had a long-term occupational history of exposure to carcinogens during the early bio-technology period. CONCLUSIONS: Causal conclusions cannot be made yet, but observation of former and present workers in biotechnological laboratories and their cancer occurrence is warranted.