Allergy and immunotoxicology in preventive and clinical medicine from theory to practice: Occupational allergy and isocyanate-induced asthma

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  • The Research Group for Allergy and Immunotoxicology, Japan Society for Occupational Health (JSOH)
  • Dobashi Kunio
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Writing Team, The Committee for AIT, JSOH Jobu Hospital for Respiratory Diseases, Gunma
  • Yoshida Takahiko
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Writing Team, The Committee for AIT, JSOH Asahikawa Medical University
  • Morimoto Yasuo
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Writing Team, The Committee for AIT, JSOH University of Occupational and Environmental Health, Japan. Institute of Industrial Ecological Sciences
  • Ueda Atsuhi
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Writing Team, The Committee for AIT, JSOH NPO Asian Health Promotion Network Center
  • Itoh Toshihiro
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Writing Team, The Committee for AIT, JSOH Asahikawa Medical University
  • Wada Hiroo
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Writing Team, The Committee for AIT, JSOH Juntendo University Graduate School of Medicine
  • Kayama Fujio
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Jichi Medical University
  • Satoh Kazuhiro
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) University of Fukui
  • Satoh Minoru
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) University of Occupational and Environmental Health, Japan
  • Shibata Eiji
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Yokkaichi Nursing and Medical Care University
  • Suganuma Narufumi
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Kochi Medical School
  • Takeshita Tatsuya
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Wakayama Medical University
  • Tsunoda Masashi
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) National Defense Medical College
  • Nishimura Yasumitsu
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Kawasaki Medical School
  • Yanagisawa Hiroyuki
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) The Jikei University School of Medicine
  • Li Qing
    The Committee Members for Allergy and Immunotoxicology (AIT), Japan Society for Occupational Health (JSOH) Nippon Medical School

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Other Title
  • 予防・臨床医学理論と実践体系におけるアレルギー・免疫毒性制御：1．職業アレルギーとイソシアネート喘息
  • ヨボウ ・ リンショウ イガク リロン ト ジッセン タイケイ ニ オケル アレルギー ・ メンエキ ドクセイ セイギョ(1)ショクギョウ アレルギー ト イソシアネート ゼンソク

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Abstract

<p>Genetic and environmental factors and their interactions cause diseases and deteriorate health (Genetic and Environmental Interaction). Exposure to environmental factors plays a major role in the deterioration of health in the workplace.</p><p>Occupational asthma (OA) is a common disorder in the workplace. Approaches to OA are well described and discussed in “Japanese Guideline for Diagnosis and Management of Occupational Allergic Diseases” by the Japanese Society of Occupational and Environmental Allergy. According to the guideline, OA and work-aggravated asthma comprise work-related asthma, and OA can be further divided into two disease entities: sensitizer-induced OA and irritant-induced OA. The guidelines also describe diagnostic and therapeutic strategies for OA. Since a definitive diagnosis of OA requires a comprehensive decision based on a detailed interview on clinical symptoms related to employment status and clinical tests, including inhalation tests of suspected substances as needed, the possibility of OA should be considered as the first step toward diagnosis of the patient. Otherwise, OA may not be diagnosed. Therapeutic strategies include exposure avoidance, environmental arrangements in the workplace, utilization of social resources for workers, and conventional pharmacotherapy for asthma.</p><p>Artificially synthesized small compounds are used in various industries and can cause allergies. For example, isocyanates are small compounds in the -NCO group, which have been toxicologically studied. It was later shown that isocyanate could cause various nontoxic adverse health effects, including allergic reactions. Since small agents with low molecular weights bind to proteins, detecting their specific immunoglobulin E (IgE) antibodies targeting small compounds is generally difficult. In contrast, isocyanate-specific IgE antibodies are detectable in individuals with isocyanate allergies.</p><p>Suspecting OA is essential in cases exposed to newly synthesized compounds, or to those that are already known but applied to new uses, which can be better understood and predicted by studying the health effects of isocyanates.</p><p>Academic interest in various issues related to allergies, immunology, and toxicology in the workplace includes clinical medicine, epidemiology, and epigenetics related to environmental exposure. Further advanced research in these areas is necessary and promising.</p>

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