ALLERGENIC EXPOSURE, IGE-MEDIATED SENSITIZATION, AND RELATED SYMPTOMSIN LAWN CUTTERS

Aims: The aims of the study conducted on lawn cutters were: (I) to eva luate exposure to pollens and molds; and (2) to assess the prevalence rate of IgE sensitization and symptoms in I elation to exposure to pol lens and molds. Methods: Environmental assessment was done with the we of personal samplers on eight workers. Our population consisted of Is t municipal park workers including 128 lawn cutters and 67 control sub jects (blue-collar workers in the hospital). A questionnaire was admin istered as well as skin prick tests with seven common inhalants includ ing pollens and eight gr ass molds. The main outcome variables were gr ass or mold sensitization (at least one of eight molds) and work-relat ed rhinitis, conjunctivitis, and rhinoconjunctivitis. Atopy and exposu re to park-related allergens, as well as sensitization to grass pollen s, were considered as explanatory factors. Smoking was taken into cons ideration as a covariant. Both presence and duration of occupational e xposure to park-related allergens were considered as parameters of exp osure. Duration of exposure (months x years of exposure as lawn cutter s) was used as a continuous or as a categorical variable. Results: Env ironmental monitoring showed that the concentration of pollens and mol ds decreased in magnitude from samples collected close to lawn cutters faces, short distance away in parks, and in the general environment. There was no difference in the prevalence rates for atopy between lawn cutters (32%) and control subjects (37%). Sensitization rates to gras s pollen were also similar in lawn cutters (18%) and in control subjec ts (22%). However, there was a tendency for prevalence rates of sensit ization to molds to be greater among lawn cutters (12% to Alternaria) compared with control subjects (5%). In the logistic model atopy was s ignificantly related to grass sensitization (odds ratio [OR] = 7.2), m old sensitization (OR = 9.3), and sensitization to Alternaria (OR = 5. 8). Grass sensitization was a significant risk factor for park-related rhinitis (OR = 5.8), conjunctivitis (OR = 5.0), and rhinoconjunctivit is (OR = 9.4). Exposure for 12 years or more was associated with rhino conjunctivitis with an OR of 4.1 (95% confidence interval, 1.0-16.7). Smoking was not significantly related to any outcome. Conclusion: We c onclude that among lawn cutters exposure to pollens and molds is highe r than in the general population, atopy is the main determinant of sen sitization to these aeroallergens, and sensitization and, to a much le sser extent, exposure to grass are determinants of symptoms.