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1.
Am J Ind Med ; 2024 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-38899539

RESUMEN

BACKGROUND: U.S. construction workers experience high rates of injury that can lead to chronic pain. This pilot study examined nonpharmacological (without medication prescribed by healthcare provider) and pharmacological (e.g., prescription opioids) pain management approaches used by construction workers. METHODS: A convenience sample of U.S. construction workers was surveyed, in partnership with the U.S. National Institute for Occupational Safety and Health (NIOSH) Construction Sector Program. Differences in familiarity and use of nonpharmacological and pharmacological pain management approaches, by demographics, were assessed using logistic regression models. A boosted regression tree model examined the most influential factors related to pharmacological pain management use, and potential reductions in use were counterfactually modeled. RESULTS: Of 166 (85%) of 195 participants reporting pain/discomfort in the last year, 72% reported using pharmacological pain management approaches, including 19% using opioids. There were significant differences in familiarity with nonpharmacological approaches by gender, education, work experience, and job title. Among 37 factors that predicted using pharmacological and non-pharmacological pain management approaches, training on the risks of opioids, job benefits for unpaid leave and paid disability, and familiarity with music therapy, meditation or mindful breathing, and body scans were among the most important predictors of potentially reducing use of pharmacological approaches. Providing these nonpharmacological approaches to workers could result in an estimated 23% (95% CI: 16%-30%) reduction in pharmacological pain management approaches. CONCLUSION: This pilot study suggests specific factors related to training, job benefits, and worker familiarity with nonpharmacological pain management approaches influence use of these approaches.

2.
MMWR Morb Mortal Wkly Rep ; 69(18)2020 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-32379731

RESUMEN

Congregate work and residential locations are at increased risk for infectious disease transmission including respiratory illness outbreaks. SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is primarily spread person to person through respiratory droplets. Nationwide, the meat and poultry processing industry, an essential component of the U.S. food infrastructure, employs approximately 500,000 persons, many of whom work in proximity to other workers (1). Because of reports of initial cases of COVID-19, in some meat processing facilities, states were asked to provide aggregated data concerning the number of meat and poultry processing facilities affected by COVID-19 and the number of workers with COVID-19 in these facilities, including COVID-19-related deaths. Qualitative data gathered by CDC during on-site and remote assessments were analyzed and summarized. During April 9-27, aggregate data on COVID-19 cases among 115 meat or poultry processing facilities in 19 states were reported to CDC. Among these facilities, COVID-19 was diagnosed in 4,913 (approximately 3%) workers, and 20 COVID-19-related deaths were reported. Facility barriers to effective prevention and control of COVID-19 included difficulty distancing workers at least 6 feet (2 meters) from one another (2) and in implementing COVID-19-specific disinfection guidelines.* Among workers, socioeconomic challenges might contribute to working while feeling ill, particularly if there are management practices such as bonuses that incentivize attendance. Methods to decrease transmission within the facility include worker symptom screening programs, policies to discourage working while experiencing symptoms compatible with COVID-19, and social distancing by workers. Source control measures (e.g., the use of cloth face covers) as well as increased disinfection of high-touch surfaces are also important means of preventing SARS-CoV-2 exposure. Mitigation efforts to reduce transmission in the community should also be considered. Many of these measures might also reduce asymptomatic and presymptomatic transmission (3). Implementation of these public health strategies will help protect workers from COVID-19 in this industry and assist in preserving the critical meat and poultry production infrastructure (4).


Asunto(s)
Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Brotes de Enfermedades , Industria de Procesamiento de Alimentos , Enfermedades Profesionales/epidemiología , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Animales , COVID-19 , Infecciones por Coronavirus/prevención & control , Brotes de Enfermedades/prevención & control , Humanos , Carne , Enfermedades Profesionales/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Aves de Corral , Estados Unidos/epidemiología
3.
Am J Ind Med ; 62(5): 439-447, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31016761

RESUMEN

Recent increases in the rate of drug overdose-related deaths, the emergence of potent opioids such as carfentanil, and media reports of incidents have raised concerns about the potential for work-related exposure to a variety of illicit drugs among law enforcement officers (LEOs), other emergency responders, and other workers in the United States. To characterize the risk associated with unintentional occupational exposure to drugs, we retrospectively investigated two incidents that occurred in 2017 and 2018 where LEOs were exposed to opioid and stimulant drugs and experienced health effects. We interviewed five affected LEOs and others. We reviewed records, including emergency department documentation, incident reports, forensic laboratory results, and when available, body camera footage. Multiple drug types, including opioids and nonopioids, were present at each incident. Potential routes of exposure varied among LEOs and were difficult to characterize with certainty. Health effects were not consistent with severe, life-threatening opioid toxicity, but temporarily precluded affected LEOs from performing their essential job duties. While health risks from occupational exposure to drugs during law enforcement activities cannot currently be fully characterized with certainty, steps to prevent such exposures should be implemented now. The creation and implementation of appropriate controls plus education and training are both important to protecting first responders from these hazardous agents. To more fully characterize potential exposures, timely prospective toxicological evaluation of affected responders is recommended.


Asunto(s)
Analgésicos Opioides/efectos adversos , Exposición Profesional/efectos adversos , Policia , Sobredosis de Droga/etiología , Humanos , Aplicación de la Ley , National Institute for Occupational Safety and Health, U.S. , Estados Unidos
4.
Saf Health Work ; 13(4): 507-511, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36579004

RESUMEN

Law enforcement officers (LEOs) often encounter rapidly changing and uncontrolled situations that expose them to various hazards. A law enforcement agency requested an evaluation by the National Institute for Occupational Safety and Health (NIOSH) when multiple LEOs reported illness after executing a search warrant and taking a suspect into custody. NIOSH investigators interviewed LEOs and reviewed medical records, forensic laboratory results for collected evidence, and environmental testing results of samples taken after the operation. Two-thirds (25 of 38) of LEOs who participated in the operation reported ≥1 symptom. Eleven LEOs met a case definition for influenza-like illness (ILI). Members of one unit were more likely to have ILI than non-members (prevalence ratio (PR), 4.1; 95% confidence interval (CI): 1.3-13.0; p = 0.01). Influenza vaccination was associated with a lower prevalence of ILI (PR, 0.2; 95% CI, 0.1-0.9; p = 0.02). Preventing employees from working while ill and annual influenza vaccination might prevent similar occurrences.

5.
J Occup Environ Med ; 63(8): 646-656, 2021 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-34016912

RESUMEN

OBJECTIVES: To propose a framework for considering SARS-CoV-2 antigen testing of unexposed asymptomatic workers in selected workplaces. METHODS: This is a commentary based on established occupational safety and health principles, published articles, and other pertinent literature, including non-peer-reviewed preprints in medrixiv.org prior to April 16, 2021. RESULTS: Not applicable to this commentary/viewpoint article. CONCLUSION: Antigen testing is a rapidly evolving and useful public health tool that can be used to guide measures to reduce spread of SARS-CoV-2 in the community and in selected workplaces. This commentary provides a proposed framework for occupational safety and health practitioners and employers for considering antigen testing as a method to screen asymptomatic workers in selected non-healthcare settings. When applied selectively, antigen testing can be a useful, effective part of a comprehensive workplace program for COVID-19 prevention and control.


Asunto(s)
COVID-19 , Salud Laboral , Prueba Serológica para COVID-19 , Humanos , SARS-CoV-2 , Lugar de Trabajo
6.
Int Arch Occup Environ Health ; 83(7): 779-89, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20496079

RESUMEN

OBJECTIVE: To evaluate the immunosuppressive effects of job stress in female nurses, an 8-month longitudinal study was conducted at a major university hospital. METHODS: Four groups of ten subjects each were constructed to represent high versus low objective stress and high versus low subjective stress based on their responses to a job stress questionnaire and objective stress ratings of the hospital's work units. Number of white blood cells (i.e., T cells, B cells, and natural killer cells), and lymphocytic proliferation to mitogens (concanavalin A, phytohemagglutinin, and pokeweed) and toxoid (tetanus) were measured by flow cytometry and radioimmunoassay. Serum levels of hydrocortisol, IL-1ß, IFN-γ, and TNF-α, and salivary IgA were measured by enzyme-linked immunosorbent assay. The data were analyzed by repeated measures analysis of variance controlling for age and smoking. RESULTS: The level of white blood cells was lower among high objective stress group (median: 7,170/m(3); range: 5,386-10,057) compared with that among low objective stress group (8,063; 5,888-9,875) (P = 0.03), however, no other cellular blood variables were found to be significant. In terms of humoral immuno-biomarkers, the level of TNF-α was moderately lower among high objective stress group (1.7 ng/ml; 0.3-2.7) compared with that among low objective stress group (2.2; 0.5-3.5) (P = 0.07), whereas the level of total sIgA was significantly higher among higher objective stress group (72.9 end-point titer/mg/ml/min; 14.4-153.4) compared with that among low objective stress group (44.8; 9.9-123.8) (P = 0.02). CONCLUSION: The results of the study suggest that psychological job stress affects the levels of some immunological biomarkers in female nurses.


Asunto(s)
Inmunidad , Enfermeras y Enfermeros/psicología , Estrés Psicológico/inmunología , Adulto , Análisis de Varianza , Biomarcadores/sangre , Femenino , Humanos , Inmunoglobulina A/análisis , Interferón gamma/sangre , Interleucina-1beta/sangre , Recuento de Leucocitos , Estudios Longitudinales , Activación de Linfocitos , Proyectos Piloto , Saliva/química , Encuestas y Cuestionarios , Factor de Necrosis Tumoral alfa/sangre , Adulto Joven
7.
MMWR Recomm Rep ; 55(RR-8): 1-27, 2006 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-16760892

RESUMEN

Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a person's health are presented. Evidence is included about assessing exposure, clean-up and prevention, personal protective equipment, health effects, and public health strategies and recommendations. The recommendations assume that, in the aftermath of major hurricanes or floods, buildings wet for <48 hours will generally support visible and extensive mold growth and should be remediated, and excessive exposure to mold-contaminated materials can cause adverse health effects in susceptible persons regardless of the type of mold or the extent of contamination. For the majority of persons, undisturbed mold is not a substantial health hazard. Mold is a greater hazard for persons with conditions such as impaired host defenses or mold allergies. To prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust. Clinical evaluation of suspected mold-related illness should follow conventional clinical guidelines. In addition, in the aftermath of extensive flooding, health-care providers should be watchful for unusual mold-related diseases. The development of a public health surveillance strategy among persons repopulating areas after extensive flooding is recommended to assess potential health effects and the effectiveness of prevention efforts. Such a surveillance program will help CDC and state and local public health officials refine the guidelines for exposure avoidance, personal protection, and clean-up and assist health departments to identify unrecognized hazards.


Asunto(s)
Desastres , Hongos , Salud Pública , Exposición a Riesgos Ambientales/prevención & control , Vivienda , Humanos , Hipersensibilidad/prevención & control , Micosis/prevención & control , Micotoxinas/envenenamiento , Infecciones del Sistema Respiratorio/prevención & control
8.
J Occup Environ Med ; 59(11): e236-e239, 2017 11.
Artículo en Inglés | MEDLINE | ID: mdl-29116993

RESUMEN

OBJECTIVE: The aim of this study was to describe the process by which a group of subject matter experts (SMEs) in the area of occupational health and primary care developed a clinical decision support (CDS) tool addressing work-related issues, which are important in the care of patients with diabetes mellitus (DM). The CDS is intended for primary care clinicians caring for employed adults with DM. METHODS: The SME's selected guidelines for the management of DM in working adults, reviewed pertinent literature, and developed specific recommendations for action in the clinical setting. RESULTS: Multiple factors at work may adversely affect DM management. Clinicians can support working patients through education and care strategies to improve control. CONCLUSION: Improved recognition of factors at work that can have an impact on DM care provides opportunities for improved management of DM among working adults.


Asunto(s)
Sistemas de Apoyo a Decisiones Clínicas , Diabetes Mellitus/terapia , Salud Laboral , Atención Primaria de Salud , Diabetes Mellitus/sangre , Ingestión de Líquidos , Ingestión de Alimentos , Registros Electrónicos de Salud , Hemoglobina Glucada/metabolismo , Calor , Humanos , Esfuerzo Físico/fisiología , Guías de Práctica Clínica como Asunto , Horario de Trabajo por Turnos , Lugar de Trabajo/organización & administración
10.
J Occup Environ Med ; 44(7): 601-5, 2002 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12134522

RESUMEN

The extent of health effects and exposure to environmental contaminants among workers and residents indirectly affected by the September 11, 2001, attack on the World Trade Center (WTC) is unknown. The objective of this study was to evaluate concerns related to health effects and occupational exposures three months after the WTC disaster among a population of employees working in a building close to the disaster site. A cross-sectional questionnaire survey was performed of Federal employees working near the WTC site in New York City (NYC) and a comparison group of Federal employees in Dallas, Texas. An industrial hygiene evaluation of the NYC workplace was conducted. Constitutional and mental health symptoms were reported more frequently among workers in NYC compared to those in Dallas; level of social support was inversely related to prevalence of mental health symptoms. Post-September 11th counseling services were utilized to a greater degree among workers in NYC, while utilization of other types of medical services did not differ significantly between the groups. No occupational exposures to substances at concentrations that would explain the reported constitutional symptoms were found; however, we were unable to assess potential occupational exposures in the time immediately after the WTC disaster. There is no evidence of ongoing hazardous exposure to airborne contaminants among the workers surveyed. Specific causes of reported constitutional health symptoms have not been determined. Health care providers and management and employee groups should be aware of the need to address mental health issues as well as constitutional symptoms among the large number of workers in the NYC area who have been indirectly affected by the WTC disaster.


Asunto(s)
Contaminantes Ocupacionales del Aire/efectos adversos , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Salud Laboral , Terrorismo , Contaminantes Ocupacionales del Aire/análisis , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , National Institute for Occupational Safety and Health, U.S. , Ciudad de Nueva York/epidemiología , Enfermedades Profesionales/etiología , Prevalencia , Encuestas y Cuestionarios , Texas/epidemiología , Estados Unidos
11.
J Occup Environ Med ; 53(6 Suppl): S22-4, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21606848

RESUMEN

OBJECTIVE: As potential occupational exposure to nanomaterials becomes more prevalent, it is important that the principles of medical surveillance be considered for workers in the nanotechnology industry. METHODS: The principles of medical surveillance are reviewed to further the discussion of occupational health surveillance for workers exposed to nanomaterials. RESULTS: Because of the rapid evolution of nanotechnology, information may not be available to make a well-informed determination of all factors needed to evaluate risk of health effects from occupational exposure to nanomaterials. CONCLUSION: Every workplace dealing with engineered nanomaterials should conduct hazard and exposure assessments as part of an overall surveillance needs assessment for nanotechnology workers. In workplaces where risk is felt to be present, or at least cannot be ruled out, initiation of medical surveillance is prudent to protect workers' health.


Asunto(s)
Nanoestructuras/efectos adversos , Enfermedades Profesionales/prevención & control , Exposición Profesional , Vigilancia de la Población/métodos , Administración de la Seguridad/métodos , Humanos , Exposición Profesional/análisis , Exposición Profesional/prevención & control
12.
J Occup Environ Med ; 53(6 Suppl): S3-7, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21654413

RESUMEN

OBJECTIVE: This article provides an overview of the issues that arise with medical surveillance, exposure registration, and epidemiologic research involving nanomaterial workers. METHODS: An occupational health perspective is applied to detecting risks in nanomaterial workers individually and as a group. RESULTS: General principles for medical surveillance, exposure registration, and epidemiologic research are identified. A model Nanomaterial Worker Health Study is for consideration. CONCLUSIONS: The Nanomaterial Worker Health Study can be developed as a tangible action in assuring the public that steps are being taken to learn of any adverse effects from exposure to nanomaterials.


Asunto(s)
Contaminantes Ocupacionales del Aire , Nanoestructuras/efectos adversos , Enfermedades Profesionales/prevención & control , Exposición Profesional/efectos adversos , Vigilancia de la Población , Sistema de Registros , Estudios Epidemiológicos , Humanos , Investigación , Administración de la Seguridad/normas
13.
Toxicology ; 269(2-3): 128-35, 2010 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-20006668

RESUMEN

While there is a growing body of information about hazards of nanomaterials, little is known about the risks to workers exposed to them. However, workers are the first people in society that are being exposed to the growing inventory of "nano-enabled" products in commerce. The number of workers involved in the investigation, manufacture, production, and disposal of these types of products is growing. Although toxicologic research is still the highest priority, it is time to actively anticipate the health needs of workers. To date, precautionary risk management approaches have been widely advocated. Now there is a need to initiate an evolving process to identify the issues in medical surveillance, utilization of exposure registries, and the conduct of epidemiologic research. Each of these are related complex endeavors that build on the toxicologic evidence and extent of exposure. There is a need to assess the scientific basis and research needs for determining early functional changes, organ system and disease responses for use in targeted medical surveillance. There is also need for development of criteria for extrapolating toxicological data in biological systems to predict the risk of adverse outcomes in humans. In the meantime, exposure registries may be pivotal in helping societies act in the face of uncertainty in a precautionary manner, but legal, ethical, and logistical issues need resolution. Epidemiologic research will build on these efforts and may ultimately contribute critical definitive rationale for medical screening, risk assessment and management.


Asunto(s)
Contaminantes Ocupacionales del Aire/toxicidad , Nanoestructuras/toxicidad , Exposición Profesional/análisis , Sistema de Registros , Vigilancia de Guardia , Industria Química/normas , Humanos , Exposición por Inhalación/análisis , Investigación , Medición de Riesgo , Administración de la Seguridad/normas , Pruebas de Toxicidad
14.
J Occup Environ Med ; 50(5): 517-26, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18469620

RESUMEN

OBJECTIVE: Health authorities, employers, and worker representatives are increasingly faced with making decisions about occupational health surveillance of workers potentially exposed to engineered nanoparticles. This article was developed to identify options that can be considered. METHODS: The published scientific literature on health effects from engineered and incidental nanoparticles and the principles of occupational health surveillance were reviewed to describe possible options and the evidence base for them. RESULTS: Various options for occupational health surveillance were identified. The options ranged from no action targeted to nanotechnology workers to an approach that includes documentation of the presence of engineered nanoparticles, identification of potentially exposed workers, and general and targeted medical testing. CONCLUSIONS: Although the first priority should be to implement appropriate primary preventive measures, additional efforts to monitor employee health may be warranted. Continued research is needed, and the collection of such information for exposure registries may be useful for future epidemiologic studies.


Asunto(s)
Nanopartículas , Exposición Profesional , Vigilancia de la Población/métodos , Administración de la Seguridad/métodos , Monitoreo del Ambiente , Medicina Basada en la Evidencia , Humanos , Nanopartículas/efectos adversos , Nanopartículas/análisis , Enfermedades Profesionales/prevención & control , Exposición Profesional/efectos adversos , Exposición Profesional/prevención & control , Medicina del Trabajo/métodos
16.
Am J Respir Crit Care Med ; 171(7): 792-8, 2005 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-15657460

RESUMEN

Hypersensitivity pneumonitis (HP) develops after inhalation of many different environmental antigens, causing variable clinical symptoms that often make diagnosis uncertain. The prevalence of HP is higher than recognized, especially its chronic form. Mechanisms of disease are still incompletely known. Strategies to improve detection and diagnosis are needed, and treatment options, principally avoidance, are limited. A workshop recommended: a population-based study to more accurately document the incidence and prevalence of HP; better classification of disease stages, including natural history; evaluation of diagnostic tests and biomarkers used to detect disease; better correlation of computerized tomography lung imaging and pathologic changes; more study of inflammatory and immune mechanisms; and improvement of animal models that are more relevant for human disease.


Asunto(s)
Alveolitis Alérgica Extrínseca/diagnóstico , Alveolitis Alérgica Extrínseca/etiología , Investigación/tendencias , Adulto , Alveolitis Alérgica Extrínseca/epidemiología , Animales , Niño , Preescolar , Modelos Animales de Enfermedad , Exposición a Riesgos Ambientales/efectos adversos , Necesidades y Demandas de Servicios de Salud , Humanos , Ratones , Exposición Profesional/efectos adversos , Pronóstico , Medición de Riesgo , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos X
17.
Appl Occup Environ Hyg ; 18(11): 953-60, 2003 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-14555449

RESUMEN

Hypersensitivity pneumonitis (HP) was identified among employees in an automobile parts manufacturing facility. Mycobacteria immunogenum (MI) was identified as a metal removal fluid (MRF) contaminant at this facility and had been identified as a contaminant in other facilities where HP had occurred. We therefore questioned whether measurement of MI-specific cell-mediated immunity would be associated with HP in this facility. We also questioned whether measures of cell-mediated immunity would be more informative about the presence of HP than evaluation of serum anti-MI antibody levels. Workers were categorized for exposure and disease status by questionnaire and review of medical records. Cell-mediated immunity to MI was assessed by measuring in vitro secretion of cytokines (interleukin 8, tumor necrosis factor alpha, and interferon-gamma) from peripheral blood mononuclear cells or anticoagulated whole blood induced by culture with MI antigen. Serum antibodies against MI were also measured. Six study participants met our survey definition for HP and 48 did not. As has been reported for various agents causing HP, serum antibody levels against MI were increased in both exposed workers and workers with HP. Serum antibodies did not distinguish between the two. When expressed as a percentage of secretion induced by lipopolysaccharide, MI induced a significant increase in interleukin-8 secretion in exposed participants' whole blood cultures. There were trends for increased MI-induced secretion of interferon-gamma by peripheral blood mononuclear cells from both exposed workers and workers with HP. However, these trends did not attain statistical significance. Thus, several measures of immunity to MI distinguished between exposed and unexposed workers but not between workers with and without HP. These evaluations of cell-mediated immunity were not more informative than measurement of serum antibodies. As was done at this facility, institution of a comprehensive safety and health plan for MRF is necessary to eliminate (or minimize) health effects related to occupational exposures in the machining environment.


Asunto(s)
Alveolitis Alérgica Extrínseca/epidemiología , Aceites Industriales/efectos adversos , Metalurgia/instrumentación , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Adulto , Alveolitis Alérgica Extrínseca/diagnóstico , Alveolitis Alérgica Extrínseca/microbiología , Encuestas Epidemiológicas , Humanos , Masculino , Infecciones por Mycobacterium/epidemiología , Infecciones por Mycobacterium/microbiología , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/microbiología , Estados Unidos/epidemiología
18.
Ann Allergy Asthma Immunol ; 92(5): 483-91; quiz 492-4, 575, 2004 May.
Artículo en Inglés | MEDLINE | ID: mdl-15191015

RESUMEN

OBJECTIVE: To review and summarize current evidence regarding the proper role of immunoassays in clinical assessments of exposure to fungi and health effects related to fungal exposure. DATA SOURCES: We reviewed relevant scientific investigations and previously published reviews concerning this topic. STUDY SELECTION: The authors' clinical, laboratory, and public health experiences were used to evaluate relevant data for scientific merit. RESULTS: Testing to determine the presence of IgE to specific fungi may be a useful component of a complete clinical evaluation in the diagnosis of illnesses that can be caused by immediate hypersensitivity such as allergic rhinitis and asthma. Detection of IgG to specific fungi has been used as a marker of exposure to agents that may cause illnesses such as hypersensitivity pneumonitis. However, the ubiquitous nature of many fungi and the lack of specificity of fungal antigens limit the usefulness of these types of tests in the evaluation of potential building-related illness and fungal exposure. Specific serologic tests (such as tests for cryptococcal antigen, coccidioidal antibody, and Histoplasma antigen) have been shown to be useful in the diagnosis of some fungal infections, but these are the exception not the rule. CONCLUSIONS: There is currently not enough scientific evidence to support the routine clinical use of immunoassays as a primary means of assessing environmental fungal exposure or health effects related to fungal exposure. Health care providers who care for persons expressing concerns about the relationship of symptoms to potential exposure to fungi are advised to use immunoassay results with care and only as an adjunct to a comprehensive approach to patient care.


Asunto(s)
Exposición a Riesgos Ambientales , Microbiología Ambiental , Hongos/inmunología , Hipersensibilidad Inmediata , Animales , Anticuerpos Antifúngicos/inmunología , Antígenos Fúngicos/inmunología , Preescolar , Humanos , Inmunoensayo , Masculino , Micosis/inmunología
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