噴漆作業勞工過敏疾病之皮膚貼膚測驗與抗體檢驗之相關性研究

A Study of Patch Test and Antibody Measurement for Occupational Allergy in Spray Painters

噴漆作業之勞工常發生皮膚、呼吸道及眼睛等症狀。本研究針對常接觸噴漆作業相關的勞工，以問卷方式調查上述三種職業性過敏病。同時赴工作現場進行皮膚貼膚試驗，並抽血檢測血清中的專一性抗體，以研究其與過敏症狀之相關性。我們收集暴露組勞工 94 人。結果顯示：在 91 份有效問卷中，有皮膚症狀且與工作有關者占 18.7%（17/91） ；有呼吸道症狀且與工作有關者占 16.0%（15/91） ，有眼睛症狀且與工作有關者占 23.0%（21/91） 。94人接受貼膚試驗，陽性反應之前四項過敏原為：Gold sodium thiosulfate，11人有反應占 11.7%；2-n-Octyl-4-isothiazolin- 3-one，9 人有反應占 9.6%；Nickel sulfate hexahydrate，6 人有反應占 6.4%；Me-isothiazolinone/Me-Cl-isothiazolinone，5 人有反應占 5.3%。80 人接受血清 IgG1 檢測，陽性反應之前四項：Me-isothiazolinone/Me-Cl-isothiazolinone，14 人有反應占 17.5%；Diethyleneglycol diacrylate，11 人有反應占 13.8%；Nickel sulfate hexahydrate，9 人有反應占 11.3%；4,4- Diaminodiphenylmethane，9人有反應占11.3%。各種過敏原之貼膚反應與血清反應沒有相關性，但有皮膚症狀之勞工較容易有貼膚試驗陽性反應，其 P<0.001，而有呼吸道過敏反應症狀的勞工較容易有血清 IgG1 陽性反應，其 P<0.001（r = 0.803） 。結論：我們調查噴漆作業勞工出現眼睛過敏的比率最高，而貼膚試驗最能反應出皮膚症狀，血清IgG1試驗最能反應出呼吸道過敏。

There are many reports of irritant and allergic contact dermatitis and respiratory diseases from spray paint workers. A survey of paint-related occupational diseases, based on a questionnaire, clinical examination and patch testing, was carried out among present and former employees. Furthermore, partially selected workers were investigated with serum specific IgG1 antibody determination. A total of 94 painters were recruited, but only 91 painters completed the questionnaire. The results showed that there were 17 workers (18.7%) have work related skin allergic symptoms, 15 workers (16.0%) have work related respiratory symptoms and 21 workers (23.0%) have work related eye symptoms. There were 94 workers received patch tests. The four common antigens were: Gold sodium thiosulfate with 11 (11.7%) workers reacted, 2-n-Octyl-4-isothiazolin-3-one with 9 (9.6%) workers reacted, Nickel sulfate hexahydrate with 6 (6.4%) workers reacted, Me-isothiazolinone/Me-Cl-isothiazolinone with 5 (5.3%)workers reacted. There were 80 workers received sera IgG1 measurements: The four common antigens were Me-isothiazolinone/Me-Cl-isothiazolinone 14 (17.5%) workers reacted, Diethyleneglycol diacrylate 11 (13.8%) workers reacted, Nickel sulfate hexahydrate 9 (11.3%)workers reacted, 4,4- Diaminodiphenylmetane 9 (11.3%)workers reacted. Skin symptoms were correlated with patch test results with p<0.001; and respiratory symptoms were correlated with sera IgG1 results with r = 0.803, p<0.001. However, there was no correlation between patch test and sera IgG1 results. In conclusion, the most common work-related clinical features are eye symptoms. Skin symptoms can be detected by using sera IgG1. These results provide us a useful strategy to prevent work-related clinical symptoms among spray paint workers.