CLINICAL AND IMMUNOLOGICAL EVALUATION OF WORKERS EXPOSED TO GLUTARALDEHYDE

We describe immunologic responses in subjects exposed to glutaraldehyd e (GA) who were diagnosed as having occupational asthma, or who descri bed work-related respiratory symptoms. A series of GA-modified protein s was characterized, and used to analyse sera from 20 GA-exposed worke rs and 21 unexposed workers for ISE antibodies. Inhibition studies wer e used to determine the specificity of binding. The reaction of GA wit h albumin in different molar ratios produced a range of modified prote ins, which were used to measure specific IgE antibodies. A significant difference between exposed and unexposed subjects with serum IgE less than 150 kU/l could be detected for GA-specific IgE antibodies (P = 0 .026), and 31% of exposed workers with occupational asthma had antibod y levels greater than the unexposed population (mean +2.5 SD). False-p ositive results were obtained with serum from unexposed workers who ha d total IgE levels greater than 150 kU/l, but this binding was not inh ibited by GA-modified proteins. We report the first evidence of immuno logic sensitization in some workers exposed to GA. However, GA may beh ave like many other low-molecular-weight chemicals in that specific an tibodies can be detected in only a small percentage of exposed workers who report work-related respiratory symptoms.