Some epidemiological characteristics of allergy to betalactam antibiotics in pharmaceutical industrial workers and hospital staffs

Some epidemiological characteristics of allergy to betalactam antibiotics in pharmaceutical industrial workers and hospital staffs

J ALLERGY CLIN IMMUNOL VOLUME 109, NUMBER 1 when inspected. A positive SPT was recorded in 24.9% of the children, i.e.18.7% to grasses, 12.9% to cat,...

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J ALLERGY CLIN IMMUNOL VOLUME 109, NUMBER 1

when inspected. A positive SPT was recorded in 24.9% of the children, i.e.18.7% to grasses, 12.9% to cat, 3.6 to trees, 2.9% to D. pter, 1.4% to D. farinae and 0.5% to alternaria. CONCLUSION: The high prevalence of atopic diseases in children at 10-11 years is surprising as the prevalence in adults is very low in Iceland. The findings resemble those in developing countries. Other changes in environmental factors would be operative, however, as Iceland has had an affluent lifestyle for a considerable time. The high prevalence of sensitivity to grass pollen may be explained by the long grass pollen season and low exposure to other allergens on the island.

1Q~ Some Epidemiological Characteristics of Allergy to Betalactam IMIl, I Antibiotics in Pharmaceutical Industrial Workers and Hospital Staffs Tuan Le Pham*, An Nang Nguyen§ *Hanoi City Department of Health, Hanoi, Vietnam §Bach Mai Hospital, Hanoi, Vietnam OBJECTIVE: To determine the prevalence of allergy to betalactam antibiotics and find out the association factors to that prevalence. M E T H O D S : Cross-sectional descriptive study. 490 workers from 3 Pharmaceutical enterprises; 589 hospital staffs (nurses, pharmacist) from 7 hospitals in Hanoi Capital were interviewed about the time of occupational contact to betalactam, the working section, the allergic history to betalactam. A control group 596 persons who work in the environment without contacting to betalactam. Skin prick test with Benzyl Penicillin G, total serum IgE concentration test and mast cell transformation test were done in the subjects who had allergic history to betalactam. RESULTS: Allergic prevalence to betalactam in pharmaceutical workers and hospital staffs is very high (12.23%). Prevalence in pharmaceutical workers is 15.71%, in hospital staffs is 9.34% and higher than prevalence of control group (2.35%, p<0.05). Among betalactam family, allergy due to penicillin is highest (55.68%), following is ampicillin (34.09%). Amoxycillin and cephalecin have low prevalence (7.39, 2.84%). Group of subjects with working time from and above 10 years had 2.3 times the risk of getting allergy to betalactam antibiotics as compared with the one under 10 years (RR= 2.3; CI 95%: 1.23 - 4.42; p<0.05). Group of subjects with directly contact time to betalactam from and above 10 years had 2.17 times the risk of getting allergy to betalactam as compared with the one under 10 years (RR = 2.17; C195%: 1.40 - 3.39; p<0.05). 45.38% cases had allergic reaction at work site when they contacted betalactam during working time. 48.46% cases had allergic reaction when they had to use betalactam for their disease treatment. The subject group from and above 35 years old had 1.84 times the risk of getting allergy as compared with the one under 35 years old (RR = 1.84; C195%: 1.14 - 3.00; p<0.05). There is no different of allergic prevalence to betalactam between male and female. Subjects who had allergic family history had 1.84 times the risk of developing allergy to betalactam antibiotics as compared with the others without allergic family history (p<0.05). Subjects who used to get some allergic - immunological diseases (Pneumonia, rbinitis, rheumatis, eczema etc.) had 2.25 times the risk of developing allergy to betalactam as compared with the others without those diseases (p<0.05). CONCLUSIONS: The prevalence of allergy to betalactam antibiotics in pharmaceutical workers and hospital staffs is very high and clearly affected by occupational factors. This issue requires the functioning agencies having solutions of early detection, management and prevention for labor force working in pharmaceutical and health branch.

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87 scriptions Childhood Epidemiology of Anaphylaxis and Epinephrine Prein Wales: 1994-1999 Satyapal Rangaraj, David Tuthill, Michael Burr, Mazin Alfaham Llandough Hospital, Cardiff, UK BACKGROUND: There has been variable increase in the incidence of anaphylaxis throughout the world. However the mortality from anaphylaxis has remained unchanged. Few data exist about prescription habits of selfinjectable epinephrine by General Practitioners. OBJECTIVES: To describe the epidemiology of: 1. Anaphylaxis and allergic reactions in children less than 15 years and 2. EpiPen and EpiPen junior prescriptions by General Practitioners in Wales from 1994-99. M E T H O D S : This was a retrospective population based study. The incidence of anaphylactic reactions was obtained by International Classification of Diseases coding from Health Solution Wales. Health Solution Wales records prospective data on the incidence of all diseases and NHS prescriptions in Wales. All children with anaphylaxis and allergic reactions were included. Those with reactions due to iatrogenic causes were excluded. EpiPen and EpiPen junior prescription rates in primary care through out Wales were obtained from Health Solution Wales. The population estimates and social class distribution for various regions in Wales were obtained from the Government Statistical Service. RESULTS: The incidence of allergy and anaphylaxis, EpiPen and EpiPen junior prescriptions are given in the table below. Comparison of the socio-economic status between different regions in Wales and EpiPen prescriptions revealed a positive correlation between EpiPen prescription and higher socio-economic class (Correlation coefficient = 0.28). DISCUSSION: 1) The 5 fold increase in allergy and anaphylaxis has produced a 20 fold rise in EpiPen prescriptions. 2) The association between EpiPen prescriptions and regions of higher socio-economic class is intriguing.

Allergy & Anaphylaxis/lO00 population 1994 1995 1996 1997 1998 1999

0.08 0.18 0.31 0.27 0.35 0.33

EpiPen/lO00 EpiPenjunior/lO00 population population 0.01 0.04 0.06 0.09 0.17 0.20

0.02 0.05 0.31 0.16 0.17 0.20

8 8 C o r d Blood Level of IgE Specific for Dermatophegoides PteronyssinusCan Predict Allergic Manifestations in Infancy Mitsuhiko Nambu Tenri Hospital, Tenri City, Japan Total IgE and egg white-specific IgE levels in cord blood have been reported to be related to the development of allergic disorders. The aim of this study was to investigate the relationship between the cord blood level of IgE specific for Dermatophagoides pteronyssinus (Dp-IgE) and the development of allergic disorders in infants. Dp-IgE levels in cord blood from 74 babies were measured by the Lumiward system. Maternal atopy was defined as a total IgE level of more than 230IU/ml or a Dp-IgE level of more than 0.70IU/ml in the peripheral blood. At 10 months and at 3 years of age, the infants were assessed for allergic disorders. None of the ten infants without a family history of allergic disorders and with a cord blood Dp-IgE level of less than 0.07IU/ml developed atopic dermatitis at 10 months of age. When maternal atopy was present, infants with a cord blood Dp-IgE level of 0.07IU/ml or more showed a higher prevalence of allergic disorders by 3 years of age than those with a cord blood Dp-IgE level of less than 0.07IU/ml. These observations suggest that the cord blood Dp-IgE level can predict allergic manifestations in infancy, although possible contamination of cord blood samples by maternal blood cannot be ignored.