Diagnostic Accuracy of Specific IgE Against Wheat and Rye in Flour-Induced Occupational Asthma.

BACKGROUND: Assessment of IgE-mediated sensitization to flour allergens is widely used to investigate flour-induced occupational asthma. The diagnostic efficiency of detecting specific IgE antibodies (sIgEs) against wheat and rye flour, however, has not been thoroughly compared with other diagnostic procedures. OBJECTIVE: We sought to evaluate the diagnostic accuracy of sIgE against wheat and rye compared with specific inhalation challenge (SIC) with flour as the reference standard. METHODS: This retrospective multicenter study included 264 subjects who completed an SIC with flour in eight tertiary centers, of whom 205 subjects showed a positive SIC result. RESULTS: Compared with SIC, sIgE levels of 0.35 kUA/L or greater against wheat and rye provided similar sensitivities (84% to 85%, respectively), specificities (71% to 78%), positive predictive values (91% to 93%), and negative predictive values (56% to 61%). Increasing the threshold sIgE value to 5.10 kUA/L for wheat and to 6.20 kUA/L for rye provided a specificity of 95% or greater and further enhanced the positive predictive value to 98%. Among subjects with a positive SIC, those who failed to demonstrate sIgE against wheat and rye (n = 26) had significantly lower total serum IgE level and blood and sputum eosinophil counts and a lesser increase in postchallenge FeNO compared with subjects with a detectable sIgE. CONCLUSION: High levels of sIgE against wheat and/or rye flour strongly support a diagnosis of flour-induced occupational asthma without the need to perform an SIC. The absence of detectable sIgE against wheat and rye in subjects with a positive SIC seems to be associated with lower levels of TH2 biomarkers.

[Individual dosimetry as an element of health prevention for employees exposed to ionizing radiation]. / Dozymetria indywidualna jako element profilaktyki zdrowotnej pracowników narazonych na promieniowanie jonizujace.

The paper presents the current radiation protection standards, in line with the recommendations of the International Commission on Radiological Protection (ICRP), and their evolution over the years based on new knowledge about the biological effects of ionizing radiation and the changing attitude of people to the accepted risk. The work takes into account in particular the role of the dose limit principle and individual dose measurements in activities aimed at health prevention of individual people occupationally exposed to ionizing radiation. Med Pr Work Health Saf. 2023;74(6):527-39.

Recognition COVID-19 as an occupational disease in Poland - definition, criteria and recommendation.

A major challenge over the pandemic period was to establish the criteria for recognizing COVID-19 as an occupational disease. The European Center for Disease Prevention and Control has attempted to estimate the incidence of COVID-19 in individual occupational groups and economy sectors in the European Union and the United Kingdom, and to identify possible factors increasing the transmission of the virus at workplaces. Legal regulations of various countries in the world allow COVID-19 to be recognized as an accident at work and/or an occupational disease. In Poland, an occupational disease is defined as a disease caused by harmful factors occurring in the work environment or connected with performing a given job, included in the official list of occupational diseases. When assessing occupational exposure in the healthcare sector, it should be considered that healthcare workers include all persons in contact with patients or their biological material, as well as employees who are not medical professionals but who share a common space with patients due to the nature of their work. The latter group includes administrative and technical employees, control and rescue service workers, people supporting medical staff, and employees of nursing homes. In the case of non-medical occupations, the decision to recognize COVID-19 as an occupational disease should be made on an individual basis, after confirming a significant risk of contracting a SARS-CoV-2 virus infection at the workplace and in the absence of evidence of a non-occupational source of infection. An assessment of occupational exposure should always include evaluating the possibility of SARS-CoV-2 transmission. Med Pr Work Health Saf. 2023;74(5):435-42.