Grammer LC, Shaughnessy MA, Yarnold PR, Risk factors for immunologically mediated disease in workers with respiratory symptoms when exposed to hexahydrophthalic anhydride, J Lab Clin Med, 1996;127:443-447,

BOHRF Original Authors' Main Conclusions

The original authors' main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.

Study aimed to identify risk factors for development of immunologically mediated disease in workers with respiratory symptoms associated with exposure to hexahydrophthalic anhydride (HHPA). Of the 33 employees with respiratory symptoms, 20 had no immunologically mediated disease. 7 had both IgE-mediated and IgG-mediated disease, 5 had IgE-mediated disease only, and 1 had IgG-mediated disease only. A larger sample would have rendered atopy a statistically significant risk factor (assuming effect replication). However, as expected, elevated levels of specific antibodies were statistically and clinically significant risk factors. Development of one type of immunologically mediated disease was highly predictive of development of the other type. In HHPA-exposed employees with respiratory symptoms, development of immunologically mediated respiratory disease is most closely associated with presence of specific IgE or IgG antibodies. Neither race, age, smoking status, atopy, nor exposure levels emerged as significant risk factors in this symptomatic study population.

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